Individual provider Active NPI

Cathy Clifton

  • Dental Hygienist
  • Fort Campbell, KY
National Provider Identifier
1174972061
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2178 Issued in TN
Practice address
BLDG 2441 21St Street
US Army Dental Activity
Fort Campbell, KY 42223
Phone
(270) 798-5429
Fax
(270) 956-0266
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2178 TN Primary

Addresses

Primary practice location

BLDG 2441 21St Street
US Army Dental Activity
Fort Campbell, KY 42223

Mailing address

BLDG 2441 21St Street
US Army Dental Activity
Fort Campbell, KY 42223
Phone (270) 798-5429

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

LicenseStateTypeSpecialty
2178TNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1174972061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-5429",
            "fax_number": "270-956-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-5429",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "CATHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "2178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.