Individual provider Active NPI

Lawrence P Clinton, M.D.

  • Psychiatry Physician
  • Vineland, NJ
National Provider Identifier
1316003734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA03018600 Issued in NJ
Practice address
1138 E Chestnut Ave
Building 6a
Vineland, NJ 08360-5053
Phone
(856) 696-2660
Fax
(856) 696-8548
NPI assigned
Dec 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA03018600 NJ Primary

Addresses

Primary practice location

1138 E Chestnut Ave
Building 6a
Vineland, NJ 08360-5053

Mailing address

1138 E Chestnut Ave
Building 6a
Vineland, NJ 08360-5053
Phone (856) 696-2660

Other identifiers 3

IdentifierTypeStateIssuer
2920204MedicaidNJ
0074628000OtherNJAMERIHEALTH
049091OtherNJVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060105000904 NJ Practitioner - Psychiatry 3678596566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03018600NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence P. Clinton, M.D., P.a. Psychiatry CurrentSince Jun 10, 1978 Accepting new patients

Locations

1138 E Chestnut Ave
Ste 6A
Vineland, NJ 08360
Phone (856) 696-2660

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316003734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE",
            "address_2": "BUILDING 6A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605053",
            "telephone_number": "856-696-2660",
            "fax_number": "856-696-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE",
            "address_2": "BUILDING 6A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605053",
            "telephone_number": "856-696-2660",
            "fax_number": "856-696-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "LAWRENCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03018600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2920204",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0074628000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "049091",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.