Organization Active NPI

Clayton Primary Care Group, Inc

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1154571776
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CLAYTON PRIMARY CARE GROUP, INC
Practice address
3009 N Ballas Rd
Suite 300 a
Saint Louis, MO 63131-2322
Phone
(314) 872-9900
Fax
(314) 872-3939
NPI assigned
Sep 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Authorized official

Name
J Collins Corder, M DNPI 1184698987
Title
Owner/Partner
Phone
(314) 872-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3009 N Ballas Rd
Suite 300 a
Saint Louis, MO 63131-2322

Mailing address

3009 N Ballas Rd
Suite 300 a
Saint Louis, MO 63131-2322
Phone (314) 872-9900

National Provider Directory

National Provider Directory

Locations

910 S Kirkwood Rd
Ste 190
Saint Louis, MO 63122
Phone (314) 822-2701

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1154571776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "SUITE 300 A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-872-9900",
            "fax_number": "314-872-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "SUITE 300 A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-872-9900",
            "fax_number": "314-872-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON PRIMARY CARE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "CORDER",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "COLLINS",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "314-872-9900",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

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