Clayton Outpatient Surgical Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

031-070 Issued in GA

Legal business name

CLAYTON OUTPATIENT SURGICAL CENTER

Practice address

6911 Tara Blvd
Suite 104
Jonesboro, GA 30236-1503

Phone

(770) 477-9535

Fax

(770) 471-7826

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Stanley Kalish, DPMNPI 1811994379

Title

Medical Director

Phone

(770) 477-9535

Specialties & licenses 1

Addresses

Other identifiers 2

Listed as

Clayton Outpatient Surgical CenterCCN 11C0001048

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanley Richard Kalish, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jonesboro, GA
  • NPI 1811994379
  NPD Authorized official

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1538166012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 TARA BLVD",
            "address_2": "SUITE 104",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361503",
            "telephone_number": "770-477-9535",
            "fax_number": "770-471-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 TARA BLVD",
            "address_2": "SUITE 104",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361503",
            "telephone_number": "770-477-9535",
            "fax_number": "770-471-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON OUTPATIENT SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "KALISH",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-477-9535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "031-070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00649833A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490002632",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Mhddad
• Clayton Mhddad
• Clayton Mhddad
• Clayton Mhddad
• Clayton Mobile Diagnostic Clinic
• Cassandra Clayton
• Teresa Cleaves, CSA
• Desiree Clement, CNM
• Roza Elena Clempus, M.D.
• Lashaunda Denise Clerizier, APRN

• Ambulatory Surgical Clinic/Center in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.