Kelly Clayton FNP Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

200150078NP Issued in OR

Legal business name

KELLY CLAYTON FNP INC

Doing business as

Health Care By House Call

Practice address

387 Pinetop Terrace
Shady Cove, OR 97539

Phone

(541) 878-3537

NPI assigned

Jul 8, 2008

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Marie Clayton, FNP

Title

President

Phone

(541) 878-3537

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Health Care By House Call Doing business as

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1104089309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "975390001",
            "telephone_number": "541-878-3537",
            "fax_number": "541-878-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 PINETOP TERRACE",
            "city": "SHADY COVE",
            "state": "OR",
            "postal_code": "97539",
            "telephone_number": "541-878-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CLAYTON FNP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-878-3537",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "200150078NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1396744769",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228862",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Care By House Call",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor Austin Ellson, DMD
• Kathleen Finley
• Kristen Ranae Gerhardt
• Rhonda Grayson
• Kathleen S Finley (Shady Cove Clinic)
• Dan Dale Kelly
• Phillip Bruce Lassen, D.M.D.
• Laura L. Johnson, N.P., P.C. (Crater Lake Medical South)
• Mending Waters Counseling LLC
• Lila R Moschetti, RPH

• Primary Care Clinic/Center in Shady Cove, OR
• Providers in Shady Cove, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.