NPIMap

Organization Active NPI

Clayton Urgent Care and Family Clinic PA

  • General Practice Physician
  • Clayton, NC
National Provider Identifier
1104912096
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CLAYTON URGENT CARE AND FAMILY CLINIC PA
Practice address
11491 US Highway 70 W
Clayton, NC 27520
Phone
(919) 550-2484
Fax
(919) 550-7059
NPI assigned
Oct 5, 2006
Last updated
Aug 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Authorized official

Name
Nena Reeves
Title
Director of Business Development
Phone
(919) 550-0821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

11491 US Highway 70 W
Clayton, NC 27520

Mailing address

935 Shotwell Rd
Suite 108
Clayton, NC 27520
Phone (919) 550-0821

Other identifiers 3

IdentifierTypeStateIssuer
5948370OtherAETNA
89015PAMedicaidNC
0139VOtherNCBCBS OF NC GROUP NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1104912096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SHOTWELL RD",
            "address_2": "SUITE 108",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-550-0821",
            "fax_number": "919-550-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11491 US HIGHWAY 70 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-550-2484",
            "fax_number": "919-550-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON URGENT CARE AND FAMILY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "NENA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "919-550-0821"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5948370",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015PA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC GROUP NUMBER",
            "identifier": "0139V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.