Individual provider Active NPI

Robert Eric Clayton, M.D.

  • Family Medicine Physician
  • Wendell, NC
National Provider Identifier
1477518413
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30615 Issued in NC
Practice address
4111 Wendell Blvd
Wendell, NC 27591-6831
Phone
(919) 365-8484
Fax
(919) 365-8450
NPI assigned
Apr 20, 2006
Last updated
Oct 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30615 NC Primary

Addresses

Primary practice location

4111 Wendell Blvd
Wendell, NC 27591-6831

Mailing address

4111 Wendell Blvd
Wendell, NC 27591-6831
Phone (919) 365-8484

Other identifiers 1

IdentifierTypeStateIssuer
1477518413OtherNCNPI

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
I20050422000975 NC Practitioner - Family Practice 8729026372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4111 Wendell Blvd
Wendell, NC 27591-6831
Phone (919) 365-8484

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30615NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MTM&M PLLC Family Medicine CurrentSince Oct 1, 2008 Accepting new patients

Locations

4111 Wendell Blvd
Wendell, NC 27591
Phone (919) 250-1106

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1477518413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 WENDELL BLVD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275916831",
            "telephone_number": "919-365-8484",
            "fax_number": "919-365-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 WENDELL BLVD",
            "city": "WENDELL",
            "state": "NC",
            "postal_code": "275916831",
            "telephone_number": "919-365-8484",
            "fax_number": "919-365-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "ROBERT",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "30615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477518413",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wendell, NC

Sources for this page

Verify at the official NPI Registry.