Clinton X-Ray Associates, PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CLINTON X-RAY ASSOCIATES, PA

Practice address

409 Cooper Dr
Clinton, NC 28328-2817

Phone

(910) 592-8070

Fax

(910) 592-8549

NPI assigned

Jul 12, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Roberts McDevitt Jr., MDNPI 1073511234

Title

President

Phone

(910) 592-8070

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Gordon Roberts McDevitt Jr., MD

  • Diagnostic Radiology Physician
  • Clinton, NC
  • NPI 1073511234
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1174521330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 619",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283290619",
            "telephone_number": "910-592-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 COOPER DR",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282817",
            "telephone_number": "910-592-8070",
            "fax_number": "910-592-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON X-RAY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "MCDEVITT",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "ROBERTS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-592-8070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890122G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0122G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinton Operating Al, LLC (The Magnolia)
• Clinton Pharmacy LLC (Clinton Drug Company)
• Clinton Surgical Associates PLLC
• Clinton Surgical PLLC (Clinton Surgical Associates PLLC)
• Clinton Urgent Care LLC
• Heather Michelle Clougherty, ATC
• CMC Geriatric Services
• Alexis Marie Coleman
• Community Home Care of Robeson County, LLC (Community Home Care and Hospice)
• Compassionate Hands & Hearts Home Care

• Diagnostic Radiology Physician in Clinton, NC
• Providers in Clinton, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.