Active NPI
Clayton Medical and Vascular Center PLLC
- Cardiovascular Disease Physician
- Clayton, NC
National Provider Identifier
1235565946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 2012-02254
- Legal business name
- CLAYTON MEDICAL AND VASCULAR CENTER PLLC
- Practice address
- 101 Winding Wood Dr
Clayton, NC 27520-4493 - Phone
- (919) 553-1911
- Fax
- (919) 553-3933
- NPI assigned
- Sep 26, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alan Nadour, M.D.
- Title
- Physician
- Phone
- (919) 553-1911
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 2012-02254 | NC | Primary |
Addresses
Primary practice location
101 Winding Wood Dr
Clayton, NC 27520-4493
Mailing address
101 Winding Wood Dr
Clayton, NC 27520-4493
Phone (919) 553-1911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131023000776 | NC | Part B Supplier - Clinic/Group Practice | 7315172673 |
Receives reassigned benefits from 2 practitioners Practice locations: Clayton, NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2162905 | Clayton Medical and Vascular Center | Certificate of waiver | Mar 4, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Cary, NC
- NPI 1326178302
Cardiovascular Disease, NC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1380153600000",
"number": "1235565946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WINDING WOOD DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275204493",
"telephone_number": "919-553-1911",
"fax_number": "919-553-3933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WINDING WOOD DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275204493",
"telephone_number": "919-553-1911",
"fax_number": "919-553-3933"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLAYTON MEDICAL AND VASCULAR CENTER PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A",
"authorized_official_last_name": "NADOUR",
"authorized_official_first_name": "ALAN",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "919-553-1911",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NC",
"license": "2012-02254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.