Kelly A Clinton, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04635 Issued in TX

Practice address

4001 W 15TH St
Suite 225
Plano, TX 75093-5841

Phone

(972) 599-2559

Fax

(972) 599-1226

NPI assigned

May 26, 2006

Sex

Female

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 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pai Participant 9 PA

  • Geriatric Medicine (Internal Medicine) Physician
  • Elgin, TX
  • NPI 1679135420
  Medicare reassignment
• Questcare Hospitalists PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1265441620
  Medicare reassignment
• The ENT & Allergy Centers of Texas, PLLC

  • Otolaryngology Physician
  • McKinney, TX
  • NPI 1144470873
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1669428876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 CARUTH HAVEN LN",
            "address_2": "APT 924",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752258143",
            "telephone_number": "214-797-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST",
            "address_2": "SUITE 225",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935841",
            "telephone_number": "972-599-2559",
            "fax_number": "972-599-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280826302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y0105",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280826303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1067023",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01057828",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280826301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Scott Cline, M.ED., BCBA
• Lara Cline, F.N.P.
• Tammy Lynn Cline, BCBA
• Cliniapy Helping House
• Clinic to Couch Care LLC
• Amanda Hayley Clorfeine-Alter, MD
• Brendon Clough, PHARMD
• Clover Anesthesia PLLC
• Clover Health LLC
• Wendy R Clubb, LCDC

• Physician Assistant in Plano, TX
• Providers in Plano, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.