Barry Alan Clanton, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101507 Issued in FL

Practice address

75 S 200 E Ste 202
Provo, UT 84606-3168

Phone

(801) 375-2207

NPI assigned

Apr 11, 2007

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Kenneth L Crump MD PC

  • Family Medicine Physician
  • Orem, UT
  • NPI 1053408450
  Medicare reassignment

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1083837348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 E 850 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632989",
            "telephone_number": "850-819-5033",
            "fax_number": "801-375-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S 200 E STE 202",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063168",
            "telephone_number": "801-375-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "BARRY",
        "middle_name": "ALAN",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanica Christopherson
• Chrysalis Utah, Inc.
• Jacob Church, PA
• Peter Joseph Clancy
• Clanton Enterprises, Series LLC
• Clarity Mental Health PLLC
• Abigail Ruth Clark
• Albert Baxter Clark, D.D.S.
• Amanda Jill Clark
• Andrew Clark, OTR/L

• Physician Assistant in Provo, UT
• Providers in Provo, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.