Jesse E Clanton, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

C5274 Issued in AR

Practice address

2302 College Ave
Conway, AR 72034-6297

Phone

(501) 513-5793

Fax

(501) 513-5417

NPI assigned

Sep 30, 2005

Last updated

Jul 29, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Conway Emergency Physicians, P.a.

  • General Practice Physician
  • Conway, AR
  • NPI 1861725871
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1033106505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793",
            "fax_number": "501-513-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793",
            "fax_number": "501-513-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "JESSE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C5274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104705001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Michelle Churchill, APN
• Shellee Cia, RECOVERY ASSISTANT
• Katherine Cianciola, ST
• Christal Morgan Cicero
• Erica J Cisler, PHARMD
• Penny D Clardy, APRN
• Carl Mark Clark, CRNA
• Carol Clark
• Dema Clark, RECOVERY ASSISTANT
• Diana Drury Clark, CF-SLP

• Emergency Medicine Physician in Conway, AR
• Providers in Conway, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.