Kelton Jon Clinner

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

20477 Issued in AL

Practice address

8700 Highway 69 S
Tuscaloosa, AL 35405-8776

Phone

(205) 342-1401

Fax

(205) 343-1406

NPI assigned

Nov 29, 2020

Last updated

Nov 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alabama CVS Pharmacy, L.L.C.

  dba CVS Pharmacy #03004

  • Pharmacy
  • Tuscaloosa, AL
  • NPI 1063516946
  NPD
• Alabama CVS Pharmacy LLC

  dba CVS Pharmacy #17862

  • Pharmacy
  • Auburn, AL
  • NPI 1619668076
  NPD (past)

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606608000000",
    "number": "1770187916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 HIGHWAY 69 S",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354058776",
            "telephone_number": "205-342-1401",
            "fax_number": "205-342-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 HIGHWAY 69 S",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354058776",
            "telephone_number": "205-342-1401",
            "fax_number": "205-343-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINNER",
        "first_name": "KELTON",
        "middle_name": "JON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AL",
            "license": "20477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rx03004@CVShealth.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8700 Highway 69 S",
            "city": "Tuscaloosa",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354058776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexis Denise Clay, CRNP
• Brian Scott Claytor, M.D.
• Barbara C Cleino, CRNP
• Carl B Clements, PH. D
• Karen Fox Clements, D.M.D.
• Stella A Clough, MSW
• Cnop LLC
• Daphne Lavette Cockrell-James
• Elizabeth Cockrum, M.D.
• Cogent Healthcare of Decatur, LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; 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.