John R Clay I, CERTIFIED PEDORTHIST
Individual provider Active NPI Specialist · Maxton, NC
NPI 1487899357 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1487899357
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 7795381 (NC)
- Practice address
- 233 Johns Road
Maxton, NC 28364-1650 - Phone
- (336) 889-5909
- Fax
- (910) 390-9002
- NPI assigned
- Dec 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7795381 | NC | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Foot Friend, Inc. | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | |||
| Oxygen Equipment & Supplies (DME) | 332BX2000X | |||
| Specialist | 174400000X | 7795381 | NC | Yes |
Addresses
Primary practice location
233 Johns Road
Maxton, NC 28364-1650
Mailing address
233 Johns Road
Maxton, NC 28364-1650
Phone (336) 889-5909
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7701886 | Medicaid | NC |
Other names
- Mr. John R Clay I
Other providers in Maxton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.