Buddy J Clayton, MD
Individual provider Active NPI Family Medicine Physician · Elizabethton, TN
NPI 1477525699 · NPPES record last updated Jan 30, 2017
Key facts
- NPI
- 1477525699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD26900 (TN)
- Practice address
- 1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895 - Phone
- (423) 542-8929
- Fax
- (423) 542-8621
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040107000076 | TN | Practitioner - Family Practice | 7618875568 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD26900 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current |
Accepting new patients | |
| Blue Ridge Medical Management Corporation | Family Medicine | Current |
Accepting new patients |
| Clayton Medical Corporation PLC | Family Medicine | Past |
Accepting new patients |
| Blue Ridge Medical Management Corporation | Past | Accepting new patients |
Locations
1497 W Elk Ave
Ste 11
Elizabethton, TN 37643
Phone (423) 542-7480
314 Rogosin Dr
Ste B
Elizabethton, TN 37643
Phone (423) 547-2761
1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380
305 Lawson Ave
Elizabethton, TN 37643
Phone (423) 543-5600
1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000
2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867
1901 S Shady St
Mountain City, TN 37683
Phone (423) 727-1100
323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD26900 | TN | Yes |
Addresses
Primary practice location
1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895
Mailing address
1497 W Elk Ave
Suite 11
Elizabethton, TN 37643-2895
Phone (423) 542-8929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3098929 | Medicaid | TN | |
| 1477525699 | Medicaid | VA | |
| 3098921 | Medicaid | TN | |
| Q003262 | Medicaid | TN | |
| 080135081 | Other | TN | RAILROAD MEDICARE |
| 1505556 | Medicaid | TN |
Other providers in Elizabethton, TN
- Scott O Caudle
- Champion Physical Therapy LLC Halls
- Heather Naomi Champney
- Christopher Manoli Chrisohon
- Vivian M Clark
- Brandon Cole
- Joshua Cole
- Millicent Danielle Combs
- Comprehensive Home Healthcare Services LLC
- Erin Kiser Contreras
All providers in Elizabethton, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.