Clyde Spencer Blackwelder, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC23746 Issued in CA

Practice address

24721 La PLZ
Dana Point, CA 92629-2509

Phone

(949) 240-2546

Fax

(949) 240-3804

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blackwelder Chiropractic, Inc.

  • Chiropractor
  • Dana Point, CA
  • NPI 1538244769
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992880199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25762 VIA DEL REY",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754444",
            "telephone_number": "949-240-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24721 LA PLZ",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292509",
            "telephone_number": "949-240-2546",
            "fax_number": "949-240-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "CLYDE",
        "middle_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bewell Orange County LLC (Sheer Recovery LLC)
• Alisa Marie Beyer
• Maya B Bidichandani-Kaura, MD
• Wade Mattson Binley, DC
• Blackwelder Chiropractic, Inc.
• Lorilee Bohn, DC
• Carey Jamison Bornhagen, OTRL
• Judy Lynn Bourget, MD
• Bouwhuis Chiropractic Corp (Therapy Solutions)
• Dustin J Bouwhuis, D.C.

• Chiropractor in Dana Point, CA
• Providers in Dana Point, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.