Clinton Conell Price, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

020273 Issued in LA

Practice address

22 Bermuda LN
Longview, TX 75605-2902

Phone

(903) 291-3456

Fax

(903) 663-1722

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Texas Medical Branch at Galveston, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bluebonnet Trails Community MHMR CenterGroup PAC ID 5799775409, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Bluebonnet Trails Community MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1730135864
  Medicare reassignment Care Compare group NPD
• Bluebonnet Trails Community MHMR Center

  • Rural Health Clinic/Center
  • La Grange, TX
  • NPI 1518536309
  NPD
• Bayou Healthcare, LLC

  • Psychiatric Hospital
  • Alexandria, LA
  • NPI 1083898571
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1720169253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BERMUDA LN",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052902",
            "telephone_number": "903-291-3456",
            "fax_number": "903-663-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BERMUDA LN",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052902",
            "telephone_number": "903-291-3456",
            "fax_number": "903-663-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "CLINTON",
        "middle_name": "CONELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "020273",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "L4657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1967092",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precision Assistiants PLLC
• Precision Hearing Group Inc.
• Premier Pediatrics
• Premiere Pediatrics PLLC
• Prestige Imaging, LLC
• Prime Care Hospice LLC
• Prime Care Managers, LLC
• Amanda J Prince Chen, CPNP
• Kimberly Denise Prince, APRN, FNP-C
• Erin McKenzie Prine

• Child & Adolescent Psychiatry Physician in Longview, TX
• Providers in Longview, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.
• 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.