Carlton Wayne McClellan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C002852 Issued in MD

Practice address

196 Thomas Johnson Dr
Ste 215
Frederick, MD 21702-4397

Phone

(301) 668-9988

Fax

(301) 668-9977

NPI assigned

Mar 30, 2007

Last updated

Apr 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlton.mcclellan.1@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  MD

  Medicare reassignment Care Compare group NPD
• Newbridge Spine and Pain Center LLC

  • Specialist
  • Frederick, MD
  • NPI 1790921450
  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Capital Area Pain Management Associates, LLC

  • Pain Medicine Physician
  • Frederick, MD
  • NPI 1669402939
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Newbridge Anesthesia LLC

  • Specialist
  • Frederick, MD
  • NPI 1891931556
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1477673622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "STE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-668-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "STE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-668-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "CARLTON",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C002852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine McAdams, LGPC
• Sallyann McCarthy, RN
• Michele Lee McCartney, LCSW-C, LICSW
• Alice McCormick McClain, L.AC.
• Kylea McCleary
• Max McCloskey, DPT
• Todd McCloskey, L.AC.
• Erin Louise McClure, P.A.-C
• Sharon McClurkin, LCPC
• Katherine D McComiskey

• Medical Physician Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.