Richard N Clattenburg, MD

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

042-0006288 Issued in VT

Practice address

1067 Cady Hill Rd
Perkinsville, VT 05151-9523

Phone

(802) 263-5505

Fax

(802) 263-5594

NPI assigned

Sep 19, 2005

Last updated

Jun 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1457346124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 CADY HILL RD",
            "city": "PERKINSVILLE",
            "state": "VT",
            "postal_code": "051519523",
            "telephone_number": "802-263-5505",
            "fax_number": "802-263-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 CADY HILL RD",
            "city": "PERKINSVILLE",
            "state": "VT",
            "postal_code": "051519523",
            "telephone_number": "802-263-5505",
            "fax_number": "802-263-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLATTENBURG",
        "first_name": "RICHARD",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "VT",
            "license": "0420006288",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "042-0006288",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "VT",
            "license": "042-0006288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005110",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Carole Benson
• Jane Duffy, OTR
• Maryellen Mellen
• Clif Steinberg, ND
• Women's Health Associates Inc

• Developmental - Behavioral Pediatrics Physician in Perkinsville, VT
• Providers in Perkinsville, VT by specialty
• Developmental - Behavioral Pediatrics Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.