Gary M McClernan DPM PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO2389 Issued in FL

Legal business name

GARY M MCCLERNAN DPM PA

Practice address

14741 Waterway Dr
Hudson, FL 34667-3258

Phone

(727) 432-1919

Fax

(727) 260-4170

NPI assigned

Jan 16, 2012

Last updated

May 25, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary Marc McClernan, D.P.M.NPI 1154393445

Title

President/Owner

Phone

(727) 432-1919

Specialties & licenses 1

Addresses

Other identifiers 6

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.

• Gary Marc McClernan, DPM

  • Podiatrist
  • Hudson, FL
  • NPI 1154393445
  Authorized official Same address or phone

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

{
    "created_epoch": "1326672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1346511839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14741 WATERWAY DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673258",
            "telephone_number": "727-432-1919",
            "fax_number": "727-260-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14741 WATERWAY DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346673258",
            "telephone_number": "727-432-1919",
            "fax_number": "727-260-4170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Willowbrook Dr",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337646743",
            "country_code": "US",
            "telephone_number": "727-531-0223",
            "fax_number": "727-538-4877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARY M MCCLERNAN DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-16",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "MCCLERNAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "727-432-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE GROUP",
            "identifier": "DS9118",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019585300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PO2389",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MCARE PTAN",
            "identifier": "FS503A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65368",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MCARE PTAN",
            "identifier": "65368Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Gan, MD
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• Camelia Garcia, DO
• Jill Bona Garcia, MA, CCC/SLP
• Jorge A Garcia
• Gcoc Physical Therapy
• Alexander Michael Geisenhoff, MD
• Genesis Health Development Inc (Brooks Health Development)
• Genesis Rehabilitation Services
• Genesis Rehabilitation Services

• Podiatrist in Hudson, FL
• Providers in Hudson, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.