NPIMap

Organization Active NPI

Breena Dell Clayton, OD

  • Optometrist
  • Baxter, MN
National Provider Identifier
1114341971
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3328 Issued in MN
Legal business name
BREENA DELL CLAYTON, OD
Practice address
13650 Elder Dr
Baxter, MN 56425-8818
Phone
(218) 855-5756
Fax
(218) 855-5753
NPI assigned
Feb 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Breena Dell Clayton, O.D.
Title
O.D.
Phone
(218) 855-5756

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3328 MN Primary

Addresses

Primary practice location

13650 Elder Dr
Baxter, MN 56425-8818

Mailing address

13650 Elder Dr
Baxter, MN 56425-8818
Phone (218) 855-5756

Other identifiers 1

IdentifierTypeStateIssuer
1235464314OtherMNNPI

National Provider Directory

National Provider Directory

Locations

13650 Elder Dr
Baxter, MN 56425
Phone (218) 855-5755

NPI Registry JSON

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1114341971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13650 ELDER DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258818",
            "telephone_number": "218-855-5756",
            "fax_number": "218-855-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 ELDER DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258818",
            "telephone_number": "218-855-5756",
            "fax_number": "218-855-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREENA DELL CLAYTON, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-13",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "BREENA",
        "authorized_official_middle_name": "DELL",
        "authorized_official_title_or_position": "O.D.",
        "authorized_official_telephone_number": "218-855-5756",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235464314",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.