NPIMap

Individual provider Active NPI

Clinton Kesler Atkinson, M.D.

  • Vascular Surgery Physician
  • Pinehurst, NC
National Provider Identifier
1083620280
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
200200636 Issued in NC
Practice address
5 Firstvillage Drive
Pinehurst, NC 28374
Phone
(910) 295-6831
Fax
(910) 295-0874
NPI assigned
Jul 31, 2006
Last updated
Sep 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 200200636 NC Primary

Addresses

Primary practice location

5 Firstvillage Drive
Pinehurst, NC 28374

Mailing address

5 Firstvillage Drive
PO Box 2000
Pinehurst, NC 28374
Phone (910) 295-6831

Other identifiers 1

IdentifierTypeStateIssuer
5901577MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000680 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 6002848330 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians
Pinehurst Surgical Clinic PAGroup PAC ID 4587561394, 92 clinicians
MCPC-9 LLCGroup PAC ID 1658526710, 57 clinicians

Practice addresses (Care Compare)

410 -D S Jones St
Pembroke, NC 28372-7261
Phone (910) 504-8540

5 1St Village Dr
Pinehurst, NC 28374-9495
Phone (910) 295-6831

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (843) 479-9033

809 S Long Dr
Rockingham, NC 28379-4377
Phone (910) 417-4096

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-10, LLC CurrentSince Mar 1, 2014 Accepting new patients
Scotland Memorial Hospital Inc Vascular Surgery CurrentSince Apr 1, 2009 Accepting new patients
MCPC-9, LLC CurrentSince May 1, 2017 Accepting new patients
Pinehurst Surgical Clinic PA Vascular Surgery CurrentSince Sep 26, 2005 Accepting new patients
Hamlet PPM LLC Past Accepting new patients

Locations

1600 Medical Dr
Laurinburg, NC 28352
Phone (910) 277-9164

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

6322 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6700

809 S Long Dr
Ste K
Rockingham, NC 28379
Phone (910) 417-4090

921 S Long Dr
Ste 208
Rockingham, NC 28379
Phone (910) 417-3396

1818 Doctors Dr
Sanford, NC 27330
Phone (919) 777-9005

300 Pavilion Way
Southern Pines, NC 28387
Phone (910) 295-0243

Interoperability endpoints

  • Direct secure messaging: clintonatkinson@fhss.allscriptsdirect.net
  • Direct secure messaging: clintonatkinson@sas.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/12291/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1083620280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "address_2": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "CLINTON",
        "middle_name": "KESLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "200200636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901577",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.