Individual provider Active NPI

Clayton Leo Morgan Jr., PA-C

  • Physician Assistant
  • Richlands, VA
National Provider Identifier
1174621726
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001422 Issued in VA
Practice address
6719 Governor GC Peery Hwy
Richlands, VA 24641-2484
Phone
(276) 596-6778
NPI assigned
Sep 20, 2006
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001422 VA Primary
Family Medicine Physician 207Q00000X 824 WV

Addresses

Primary practice location

6719 Governor GC Peery Hwy
Richlands, VA 24641-2484

Mailing address

118 12TH Street
Princeton, WV 24740-2352
Phone (304) 487-7936

Other practice location 1

118 12th Street
Princeton, WV 24740-2352
Phone (304) 487-7936

Other identifiers 2

IdentifierTypeStateIssuer
0053383000MedicaidWA
1174621726MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100609000837 VA Practitioner - Physician Assistant 1658457080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6719 Governor GC Peery Hwy
Suite 2450
Richlands, VA 24641-2486
Phone (276) 596-6786

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
824WVMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinch Professional Physician Services LLC CurrentSince May 1, 2011 Accepting new patients
Urgent Care, Inc. - West Virginia Past Accepting new patients
Clinch Valley Urology, LLC Past Accepting new patients
Urgent Care, Inc - West Virginia Past Accepting new patients
Clinch Professional Physician Services LLC Family Medicine Past Accepting new patients
Mountaineer Gastroenterology Inc Past Accepting new patients
Virginias Dermatology, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clayton.morgan.1@19847.direct.athenahealth.com
  • Direct secure messaging: clayton.morgan@vab.hcadirect.net
  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1174621726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 12TH STREET",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402352",
            "telephone_number": "304-487-7936",
            "fax_number": "304-431-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 GOVERNOR GC PEERY HWY",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412484",
            "telephone_number": "276-596-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 12th Street",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "WV",
            "postal_code": "247402352",
            "country_code": "US",
            "telephone_number": "304-487-7936",
            "fax_number": "304-487-7835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "CLAYTON",
        "middle_name": "LEO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001422",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053383000",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174621726",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richlands, VA

Sources for this page

Verify at the official NPI Registry.