Clayton Orthopedic Clinic

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

013727 Issued in GA

Legal business name

CLAYTON ORTHOPEDIC CLINIC

Doing business as

Eagle's Landing Bone & Joint

Practice address

1050 Eagles Landing Pkwy
Suite 103
Stockbridge, GA 30281-9020

Phone

(678) 289-5040

Fax

(678) 289-2040

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Neil Colvard Berry, M. D.

Title

Owner

Phone

(678) 289-5040

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Eagle's Landing Bone & Joint Doing business as

Locations

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1700075231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY",
            "address_2": "SUITE 103",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819018",
            "telephone_number": "678-289-5040",
            "fax_number": "678-289-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY",
            "address_2": "SUITE 103",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819020",
            "telephone_number": "678-289-5040",
            "fax_number": "678-289-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON ORTHOPEDIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "COLVARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-289-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "013727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599068A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000599068A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle's Landing Bone & Joint",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanine Clark, FNP
• Stephanie Nicole Clark
• Susan Marie Clark, PH.D
• Shanique Clarke
• Rashonda L Clay-Douthit, LCSW
• Araylyn Clements King
• Brittany Michelle Clements
• Adrienne Nicole Clemons, FNP-BC
• Clesiaventures
• Beverly Ann Cobb, LCSW

• Orthopaedic Surgery Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.