Active NPI
Robert Lee Clayborn Sr., CO
- Prosthetics Case Management
- Hampton, VA
National Provider Identifier
1124119417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- CO003671
- Practice address
- 100 Emancipation Dr
Hampton, VA 23667 - Phone
- (757) 722-9961
- Fax
- (757) 728-3173
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | CO003671 | MS | Primary |
Addresses
Primary practice location
100 Emancipation Dr
Hampton, VA 23667
Mailing address
214 Rock Creek CT
Yorktown, VA 23693-5542
Phone (662) 292-3887
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO003671 | MS | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308182400000",
"number": "1124119417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 ROCK CREEK CT",
"city": "YORKTOWN",
"state": "VA",
"postal_code": "236935542",
"telephone_number": "662-292-3887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EMANCIPATION DR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "23667",
"telephone_number": "757-722-9961",
"fax_number": "757-728-3173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYBORN",
"first_name": "ROBERT",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "CO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2011-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "MS",
"license": "CO003671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.