Charles Russell Clifton Jr., PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY2731 Issued in FL

Practice address

2121 NW 40TH Terrace
Suite B
Gainesville, FL 32605

Phone

(352) 336-2888

Fax

(352) 371-1730

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Ernest J Bordini PHD & Assoc PA

  • Psychologist
  • Gainesville, FL
  • NPI 1508846254

  Clinical

  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1366587040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 NW 40TH TER",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326055813",
            "telephone_number": "352-336-2888",
            "fax_number": "352-371-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NW 40TH TERRACE",
            "address_2": "SUITE B",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-336-2888",
            "fax_number": "352-371-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "CHARLES",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne M Clemons
• Nicole Clemons
• Victoria Lynne Clemons, CNA
• Shacondra Renita Cliatt
• Stephanie Amber Clifford, ARNP
• David Cooper Cline, DC
• Matthew Joel Cline, D.C.
• Michelle Clingan
• Robert M Clonan, CRNA
• Angela Kelly Cloonan

• Clinical Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.