Individual provider Active NPI

Teague Lon Horton, MD

  • Pediatrics Physician
  • Clinton, NC
National Provider Identifier
1376610139
Registry record updated Jul 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200300481 Issued in NC
Practice address
403 Fairview St
Clinton, NC 28328-2399
Phone
(910) 592-6011
Fax
(910) 592-0811
NPI assigned
Nov 29, 2006
Last updated
Jul 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200300481 NC Primary

Addresses

Primary practice location

403 Fairview St
Clinton, NC 28328-2399

Mailing address

403 Fairview St
Clinton, NC 28328-2399
Phone (910) 592-6011

Other identifiers 3

IdentifierTypeStateIssuer
1332XOtherBCBS
C6026OtherMEDCOST
8913324MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clintonmedicalclinic@cmci.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20110725000122 NC Practitioner - Pediatric Medicine 7517135288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinton Medical Clinic, Inc.Group PAC ID 6406821628, 14 clinicians

Practice addresses (Care Compare)

403 Fairview St
Clinton, NC 28328-2311
Phone (910) 592-6011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton Medical Clinic, Inc. Pediatrics CurrentSince Aug 1, 2022 Accepting new patients
Goldsboro Pediatrics PA Pediatrics Past Accepting new patients
Goldsboro Pediatrics PA Pediatrics Past Accepting new patients

Locations

403 Fairview St
Clinton, NC 28328
Phone (910) 590-0619

404 Fairview St
Clinton, NC 28328
Phone (910) 592-6011

Interoperability endpoints

  • Direct secure messaging: clintonmedicalclinic@cmci.allscriptsdirect.net
  • Direct secure messaging: teaguehorton@cmci.allscriptsdirect.net

Organizations & group practices 3

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658534400000",
    "number": "1376610139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011",
            "fax_number": "910-592-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FAIRVIEW ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282399",
            "telephone_number": "910-592-6011",
            "fax_number": "910-592-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "TEAGUE",
        "middle_name": "LON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200300481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1332X",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "C6026",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913324",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clintonmedicalclinic@cmci.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Clinton Medical Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DM",
            "address_1": "403 Fairview St",
            "city": "Clinton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283282399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.