Kayli Marie Clatterbuck, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2357 Issued in SC

Practice address

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Phone

(843) 692-1000

NPI assigned

Oct 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kayli Marie Pollitte Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Missouri Emergency Services, P.C.

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1134499049
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1366796377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 SOMERSET DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295723261",
            "telephone_number": "606-776-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLATTERBUCK",
        "first_name": "KAYLI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA2357",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2014017611",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLI",
            "last_name": "POLLITTE",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claritypoint Psychiatry & Wellness, LLC
• Ashley T. Clark, FNP-C
• Robert D Clark, R. PH.
• Summer Brooke Clark, PHARMD, RPH
• Ashley Elizabeth Clarke, MD
• Janet Claudfelter, PTA
• Chloe Clauser, CPM, LM
• Chelsea S Clay
• Sarah Whitney Clay, PHARMD
• Patrick Vincent Claybaugh Jr., PT, DPT, TSAC-F

• Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.