Active NPI
Matthew James Clipner
- Contractor
- Phoenix, AZ
National Provider Identifier
1942560693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 9784A
- Practice address
- 17201 N 34TH St
Phoenix, AZ 85032-2071 - Phone
- (614) 270-4607
- NPI assigned
- May 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 9784A | AZ | Primary |
Addresses
Primary practice location
17201 N 34TH St
Phoenix, AZ 85032-2071
Mailing address
17201 N 34TH St
Phoenix, AZ 85032-2071
Phone (614) 270-4607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9784A | AZ | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Kids Therapy Az LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Phoenix, AZ
- NPI 1467090597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338163200000",
"number": "1942560693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17201 N 34TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850322071",
"telephone_number": "614-270-4607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17201 N 34TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850322071",
"telephone_number": "614-270-4607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIPNER",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-28",
"last_updated": "2012-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AZ",
"license": "9784A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.