Clay Mitchell Pickard, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101261503 Issued in VA

Practice address

1 Riverside Cir Ste 300
Roanoke, VA 24016-4962

Phone

(540) 581-0254

Fax

(540) 581-0120

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: cpickard88477@direct.carilionclinic.org

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1396823142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERSIDE CIR STE 300",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164962",
            "telephone_number": "540-581-0254",
            "fax_number": "540-581-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERSIDE CIR STE 300",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164962",
            "telephone_number": "540-581-0254",
            "fax_number": "540-581-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKARD",
        "first_name": "CLAY",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "020693",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101261503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3053591",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpickard88477@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cpickard88477@direct.carilionclinic.org",
            "address_1": "1 Riverside Cir Ste 300",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Physician Associates of Virginia PC
• Physicians Care of Virginia PC
• Physicians to Children, Inc.
• Physicians to Women, Inc.
• Madelena P Picard, PA
• Ruth Pickett, RD, CDCES
• Austin Piedalue, RPH
• Coree R Pienkowski, LSA
• Amy Brame Pierce, LPC
• Christopher Pierce, MD

• Dermatology Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.