Active NPI
Robert Allen Clinton Jr., M.D.
- Family Medicine Physician
- Fayetteville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2005-00848
- Practice address
- 420 Owen Dr
Fayetteville, NC 28304-3430 - Phone
- (910) 484-1210
- Fax
- (910) 484-1347
- NPI assigned
- Oct 2, 2006
- Last updated
- Apr 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 2005-00848 | NC | |
| Family Medicine Physician | 207Q00000X | 2005-00848 | NC | Primary |
Addresses
Primary practice location
420 Owen Dr
Fayetteville, NC 28304-3430
Mailing address
420 Owen Dr
Fayetteville, NC 28304-3430
Phone (910) 484-1210
Other practice location 1
6 Regional Drive
Suite C
Pinehurst, NC 28374
Phone (910) 255-0079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
120 Southwood Dr
Clinton, NC 28328-5002
Phone (910) 592-7981
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005-00848 | NC | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CS Pacs 3 Southeast, LLC | Current | Accepting new patients | |
| NM Pacs 2 LLC | Current | Accepting new patients | |
| Inpatient Consultants of North Carolina, PC | Current | Accepting new patients | |
| Inpatient Consultants of North Carolina, PC | Family Medicine | Current | Accepting new patients |
| Physician Services, P.C. | Family Medicine | Past | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
120 Southwood Dr
Clinton, NC 28328
Phone (910) 592-7981
707 N Elm St
High Point, NC 27262
Phone (336) 885-0141
204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066
600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100
179 Combs St
Sparta, NC 28675
Phone (336) 372-2441
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.
-
- Internal Medicine Physician
- Kannapolis, NC
- NPI 1669422846
-
dba Haymount Family Practice
- Family Medicine Physician
- Fayetteville, NC
- NPI 1659663599
-
- Urgent Care Clinic/Center
- Fayetteville, NC
- NPI 1740439918
-
- Hospitalist Physician
- Raleigh, NC
- NPI 1790173680
Family Medicine
-
dba Knightdale Family Medicine
- Family Medicine Physician
- Knightdale, NC
- NPI 1356655302
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lower Cape Fear LifeCare
- Community Based Hospice Care Agency
- Wilmington, NC
- NPI 1912962697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1235222928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 OWEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043430",
"telephone_number": "910-484-1210",
"fax_number": "910-484-1347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 OWEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043430",
"telephone_number": "910-484-1210",
"fax_number": "910-484-1347"
}
],
"practiceLocations": [
{
"address_1": "6 Regional Drive",
"address_2": "Suite C",
"address_purpose": "LOCATION",
"city": "Pinehurst",
"state": "NC",
"postal_code": "28374",
"country_code": "US",
"telephone_number": "910-255-0079",
"fax_number": "910-255-0069",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLINTON",
"first_name": "ROBERT",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NC",
"license": "2005-00848",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2005-00848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.