Active NPI
Billy Clay Clanton Jr., R.PH.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Byram, MS
National Provider Identifier
1528289709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- E-09006
- Practice address
- 6745 S Siwell Rd
Byram, MS 39272-8747 - Phone
- (601) 863-2004
- Fax
- (601) 863-2016
- NPI assigned
- May 2, 2007
- Last updated
- Jan 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-09006 | MS | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | E-09006 | MS | Primary |
Addresses
Primary practice location
6745 S Siwell Rd
Byram, MS 39272-8747
Mailing address
214 Summer Hill Road
Madison, MS 39110
Phone (601) 607-7137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E09006 | Other | MS | PHARMACY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-09006 | MS | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | Past | Accepting new patients | |
| Kroger Limited Partnership I | Past | Accepting new patients | |
| Kroger Limited Partnership I | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Kroger Pharmacy #472
- Community/Retail Pharmacy
- Madison, MS
- NPI 1245415868
-
dba Kroger Pharmacy #490
- Community/Retail Pharmacy
- Byram, MS
- NPI 1467486241
-
dba Kroger Pharmacy #473
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1528289709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 SUMMER HILL ROAD",
"city": "MADISON",
"state": "MS",
"postal_code": "39110",
"telephone_number": "601-607-7137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6745 S SIWELL RD",
"city": "BYRAM",
"state": "MS",
"postal_code": "392728747",
"telephone_number": "601-863-2004",
"fax_number": "601-863-2016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANTON",
"first_name": "BILLY",
"middle_name": "CLAY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-09006",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MS",
"license": "E-09006",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "E09006",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Byram, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.