Cleanslate Medical Group of Florida, PLLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

CLEANSLATE MEDICAL GROUP OF FLORIDA, PLLC

Practice address

1128 N Laura St
Jacksonville, FL 32206-4912

Phone

(904) 425-0400

NPI assigned

Feb 16, 2017

Last updated

Jul 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Hutchison

Title

Cfo

Phone

(413) 584-2173

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1225577760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CENTURY BLVD STE 307",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143692",
            "telephone_number": "615-425-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064912",
            "telephone_number": "904-425-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEANSLATE MEDICAL GROUP OF FLORIDA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "HUTCHISON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "413-584-2173"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Clayton, RN, RTSCBC, SBD
• Kimberly Hunter Clayton, ARNP
• Lauryn Ariell Clayton
• Pauline Clayton
• William Graham Claytor, APRN
• Clear Communication Therapy, LLC
• Clear Pathways for Independence LLC
• Anna Taylor Cleary
• Anne Cleary, RMHCI
• Nicole M Cleghorn

• Addiction Medicine (Internal Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Addiction Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.