Katelyn Douglas Clifton, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN220714 Issued in GA

Practice address

501 E Long St
Claxton, GA 30417-1435

Phone

(912) 739-8001

Fax

(912) 739-5001

NPI assigned

Feb 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Family Medicine of Georgia, LLC 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
• Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/evansme-081e9909
• Direct secure messaging: katelyn.clifton@evansmemorial.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southern Family Medicine of Georgia, LLC

  • Family Medicine Physician
  • Statesboro, GA
  • NPI 1528299393

  GA

  Medicare reassignment Care Compare group NPD
• Evans Memorial Hospital Inc

  • Family Medicine Physician
  • Claxton, GA
  • NPI 1134453111
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278

  Hospital

  Care Compare affiliation
• Evans Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Claxton, GA
  • NPI 1730110826

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1285173997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580847",
            "telephone_number": "912-871-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171435",
            "telephone_number": "912-739-8001",
            "fax_number": "912-739-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "KATELYN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN220714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claxton Chiropractic LLC
• Claxton Family Dentistry LLC
• Claxton Family Dentistry LLC
• Claxton Nursing Home, Inc.
• Claxton Nursing Home, Inc.
• Coastal Plains Eye Care, LLC
• Comprehensive Billing Services
• Morgan Royal Comstock, FNP-C
• Mary Lane Cooper, PA/C
• Michala Dollar

• All providers in Claxton, GA
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.

Verify at the official NPI Registry.