Clemmons Psychiatric Associates

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

27584 Issued in NC

Legal business name

CLEMMONS PSYCHIATRIC ASSOCIATES

Practice address

2511 Neudorf Rd
Suite B
Clemmons, NC 27012-8993

Phone

(336) 778-0506

NPI assigned

Jan 11, 2016

Last updated

Jan 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Florence E Davis, M.D.

Title

Owner

Phone

(336) 778-0506

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1477919173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 NEUDORF RD",
            "address_2": "SUITE B",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 NEUDORF RD",
            "address_2": "SUITE B",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128993",
            "telephone_number": "336-778-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMMONS PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-778-0506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "27584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1538326673",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Joseph Cleary, P.T.
• Alyssa Laura Clements, PH.D.
• Clemmons Assisted Living LLC (Clemmons Village II)
• Clemmons Dermatology
• Clemmons Family Eye Care
• Clemmons Road Operating Company, LLC (Cedar Hills Center for Nursing and Rehabilitation)
• Clemmons Urgent and Primary Care, PA
• Clemmons Village Chiropractic PLLC
• Clemmons Village I LLC (Clemmons Village I)
• Cmba LLC (Brookstone Terrace)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.