Clifford Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

041757 Issued in GA

Legal business name

CLIFFORD FAMILY PRACTICE

Practice address

1355 Church Street Ext NE Ste G
Marietta, GA 30060-1099

Phone

(678) 388-1355

Fax

(770) 422-1416

NPI assigned

Jan 24, 2008

Organization subpart

No

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

Authorized official

Name

David M CliffordNPI 1255394953

Title

MD

Phone

(678) 388-1355

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Maurice Clifford, MD

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1255394953
  Medicare reassignment NPD Authorized official
• Suann Surdick Surdick, PA-C

  • Physician Assistant
  • Marietta, GA
  • NPI 1134182942
  Medicare reassignment

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1023295730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 CHURCH STREET EXT NE STE G",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601099",
            "telephone_number": "678-388-1355",
            "fax_number": "770-422-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 CHURCH STREET EXT NE STE G",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601099",
            "telephone_number": "678-388-1355",
            "fax_number": "770-422-1416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Cherokee St NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608966",
            "country_code": "US",
            "telephone_number": "678-388-1355",
            "fax_number": "770-422-1416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLIFFORD FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "678-388-1355"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "041757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleveland Venture Group (Visiting Angels, Living Assistance Service)
• Stacy Arnett Cleveland, M.S., BCBA
• Treven Cliatt
• Susie Tharpe Click, LPC
• Heather Elaine Cliff, D.C.
• David Maurice Clifford, MD
• Susan Jayne Clifton
• Jordan Hoag Cline, D.C.
• Clinic Klinic
• Clinica de la Salud Smyrna, Inc (Clinica de la salud Smyrna)

• Family Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.