Individual provider Active NPI

Charles V Clopton, Jr, M.D.

  • Family Medicine Physician
  • Ellenwood, GA
National Provider Identifier
1770514440
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
043019 Issued in GA
Practice address
195 Fairview Rd
Ellenwood, GA 30294-2722
Phone
(770) 507-0112
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 043019 GA Primary

Addresses

Primary practice location

195 Fairview Rd
Ellenwood, GA 30294-2722

Mailing address

2611 N Clark Dr
East Point, GA 30344-2342
Phone (404) 766-7518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20040602000165 GA Practitioner - Family Practice 7911989231 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Office ForceGroup PAC ID 9335481951, 58 clinicians

Practice addresses (Care Compare)

2005 Prince Ave
Athens, GA 30606-6032
Phone (706) 208-9700

7454 Hannover Pkwy S
Suite 120
Stockbridge, GA 30281-6835
Phone (678) 641-6791

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
043019GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anemonefish Inpatient Services LLC CurrentSince May 1, 2022 Accepting new patients
Camp Creek Primary Care, PC Family Medicine Current Accepting new patients
C. V. Clopton, Jr, MD, PC Family Medicine CurrentSince May 28, 1998 Accepting new patients
Clayton Healthcare, P.C. PastSince Aug 18, 2019 Accepting new patients

Locations

3890 Redwine Rd SW
Ste 100
Atlanta, GA 30331
Phone (404) 344-0059

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

195 Fairview Rd
Ellenwood, GA 30294
Phone (770) 507-0112

7454 Hannover Pkwy S
Ste 120
Stockbridge, GA 30281
Phone (678) 641-6791

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1770514440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 N CLARK DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303442342",
            "telephone_number": "404-766-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942722",
            "telephone_number": "770-507-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOPTON, JR",
        "first_name": "CHARLES",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.