Carol Denise McClellan

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

10454 Issued in NC

Practice address

5535 Highland Trace CT
Winston Salem, NC 27105-1760

Phone

(336) 926-1643

NPI assigned

Apr 21, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Gromeds to Go Transportation Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Winston Salem, NC
  • NPI 1437770351
  NPD (past) Authorized official
• Gromeds to Go Transportation Inc

  • Driver
  • Winston Salem, NC
  • NPI 1801113113
  NPD (past) Authorized official

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1780901314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 HIGHLAND TRACE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271051760",
            "telephone_number": "336-926-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 HIGHLAND TRACE CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271051760",
            "telephone_number": "336-926-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "CAROL",
        "middle_name": "DENISE",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NC",
            "license": "10454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deshawna McClain, LPN
• Donald Allan McClain, M.D., PH.D.
• Paul David McClain, M.D.
• Kendra S McClary
• Vilia McClearen, RBT
• Gregory Lamont McClellan, PT
• Sara McClintock, AGACNP
• Alexandra McClory, PA-C
• Kevan Douglas McClung, PA-C
• Rachel Leanne McClung, M.D.

• All providers in Winston Salem, NC
• Private Vehicle in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.