Reynolds Clodfelter, Jr.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2910 Issued in NC

Practice address

3141 John Humphries Wynd
Raleigh, NC 27612-5438

Phone

(919) 783-5431

NPI assigned

Aug 5, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Grew, Morter & Hartye, PA

  • Clinical Psychologist
  • Raleigh, NC
  • NPI 1023037298
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639188238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 JOHN HUMPHRIES WYND",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125438",
            "telephone_number": "919-783-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 JOHN HUMPHRIES WYND",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125438",
            "telephone_number": "919-783-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLODFELTER, JR.",
        "first_name": "REYNOLDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000762",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Clinger
• Clinical Associates Healthcare
• Clinical Healthcare Incorporated
• Richard B Clinton, MD
• Hailey Smith Clissold, PA-C
• Kerry Michelle Clodfelter, LCMHCA
• Rebecca Jeffries Cloer, FNP
• Brian Cloninger
• Tracey S Cloninger, PA-C
• Kristie Reynolds Clontz, FNP-C

• Clinical Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.