Organization Active NPI

Clayton Medical Corporation PLC

  • Surgery Physician
  • Bristol, TN
National Provider Identifier
1285746719
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD36833 Issued in TN
Legal business name
CLAYTON MEDICAL CORPORATION PLC
Practice address
350 Blountville Hwy
Bristol, TN 37620-0213
Phone
(423) 844-6120
NPI assigned
Aug 31, 2006
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Cindy Locke, CPC, CSS-P
Title
Billing Administrator
Phone
(423) 224-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD36833 TN Primary

Addresses

Primary practice location

350 Blountville Hwy
Bristol, TN 37620-0213

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Other identifiers 1

IdentifierTypeStateIssuer
3723582MedicaidTN

Other names 1

  • Lifetime Family Care DBA Piney Pluff Medical Center Former legal business name

National Provider Directory

National Provider Directory

Locations

350 Blountville Hwy
Bristol, TN 37620
Phone (423) 764-8741

Practitioners & affiliated clinicians

Practitioners 3

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1285746719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604632",
            "telephone_number": "423-224-3250",
            "fax_number": "423-224-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BLOUNTVILLE HWY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376200213",
            "telephone_number": "423-844-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON MEDICAL CORPORATION PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "423-224-3250",
        "authorized_official_credential": "CPC, CSS-P"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD36833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723582",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Family Care DBA Piney Pluff Medical Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.