Organization Active NPI

Robert Douglas Clayton, MD. PC.

  • Internal Medicine Physician
  • Suwanee, GA
National Provider Identifier
1174788079
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
035836 Issued in GA
Legal business name
ROBERT DOUGLAS CLAYTON, MD. PC.
Practice address
4060 Johns Creek Pkwy
BLDG F
Suwanee, GA 30024-1230
Phone
(678) 205-0525
Fax
(770) 604-9316
NPI assigned
Jul 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Authorized official

Name
Dr. Robert Douglas Clayton, MDNPI 1558436907
Title
Owner
Phone
(678) 205-0525

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 035836 GA Primary

Addresses

Primary practice location

4060 Johns Creek Pkwy
BLDG F
Suwanee, GA 30024-1230

Mailing address

4060 Johns Creek Pkwy
BLDG F
Suwanee, GA 30024-1230
Phone (678) 205-0525

Other identifiers 3

IdentifierTypeStateIssuer
000517338CMedicaidGA
511G700888OtherGAMEDICARE
9210293OtherGACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081001000705 GA Part B Supplier - Clinic/Group Practice 1951479120 Receives reassigned benefits from 1 practitioner
Practice locations: Suwanee, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1090375Robert Douglas Clayton MD PC4060 Johns Creek Parkway Building F, Suwanee, GA 30024Provider-performed microscopyOct 8, 2026

National Provider Directory

National Provider Directory

Locations

4060 Johns Creek Pkwy
Suwanee, GA 30024
Phone (404) 805-6167

4060 Johns Creek Pkwy
Ste F
Suwanee, GA 30024
Phone (678) 205-0525

Practitioners & affiliated clinicians

Practitioners 2

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": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1174788079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 JOHNS CREEK PKWY",
            "address_2": "BLDG F",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241230",
            "telephone_number": "678-205-0525",
            "fax_number": "770-604-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 JOHNS CREEK PKWY",
            "address_2": "BLDG F",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241230",
            "telephone_number": "678-205-0525",
            "fax_number": "770-604-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT DOUGLAS CLAYTON, MD. PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-205-0525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "035836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000517338C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "511G700888",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9210293",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.