Active NPI
Michael Gene Cloutier, M.D.
- Diagnostic Radiology Physician
- Greensboro, NC
National Provider Identifier
1598743643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 26916
- Practice address
- 1331 N Elm St
Suite 200
Greensboro, NC 27401-6302 - Phone
- (336) 274-9617
- Fax
- (336) 482-2177
- NPI assigned
- Jan 8, 2006
- Last updated
- Mar 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 26916 | NC | Primary |
Addresses
Primary practice location
1331 N Elm St
Suite 200
Greensboro, NC 27401-6302
Mailing address
1331 N Elm St
Suite 200
Greensboro, NC 27401-6302
Phone (336) 274-9617
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23149 | Other | NC | BCBSNC |
| 8923149 | Medicaid | NC | |
| 300033903 | Other | NC | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26916 | NC | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Triad Radiology Associates PLLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Winston Salem, NC
- NPI 1659485001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1598743643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 N ELM ST",
"address_2": "SUITE 200",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274016302",
"telephone_number": "336-274-9617",
"fax_number": "336-482-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1331 N ELM ST",
"address_2": "SUITE 200",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274016302",
"telephone_number": "336-274-9617",
"fax_number": "336-482-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUTIER",
"first_name": "MICHAEL",
"middle_name": "GENE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-08",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "26916",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "23149",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8923149",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300033903",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.