NPIMap

Organization Active NPI

David L. Clayton MD Inc

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1255620985
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01024951A Issued in IN
Legal business name
DAVID L. CLAYTON MD INC
Practice address
621 Memorial Dr
Suite 624
South Bend, IN 46601-1063
Phone
(574) 282-2708
Fax
(574) 282-1044
NPI assigned
Apr 4, 2011
Last updated
Apr 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Authorized official

Name
Dr. David Lee Clayton, M.D.NPI 1912988460
Title
Owner
Phone
(574) 282-2708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01024951A IN Primary

Addresses

Primary practice location

621 Memorial Dr
Suite 624
South Bend, IN 46601-1063

Mailing address

621 Memorial Dr
Suite 624
South Bend, IN 46601-1063
Phone (574) 282-2708

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301875200000",
    "number": "1255620985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "address_2": "SUITE 624",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-282-2708",
            "fax_number": "574-282-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "address_2": "SUITE 624",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-282-2708",
            "fax_number": "574-282-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L. CLAYTON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-282-2708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01024951A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.