Clement Ayanbadejo LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CLEMENT AYANBADEJO LLC

Doing business as

macley family practice and walk in clinic

Practice address

2282 Meadow Church Rd Ste 200
Duluth, GA 30097-5318

Phone

(678) 372-7880

NPI assigned

May 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Clement O Ayanbadejo, MDNPI 1154552990

Title

Family Physician

Phone

(678) 257-2832

Specialties & licenses 1

Addresses

Other names 1

• macley family practice and walk in clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clement O Ayanbadejo

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1154552990
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609372800000",
    "number": "1811553084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2282 MEADOW CHURCH RD STE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975318",
            "telephone_number": "678-257-2832",
            "fax_number": "470-282-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2282 MEADOW CHURCH RD STE 200",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975318",
            "telephone_number": "678-372-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMENT AYANBADEJO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A",
        "authorized_official_last_name": "AYANBADEJO",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "678-257-2832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "macley family practice and walk in clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "macley family practice and walk in clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timilyn Clark, OTR
• Samantha Lee Claxton, OD
• Clayton R. Davis, D.M.D., P.C.
• Amber Clayton
• Dennis J Clayton, PAC
• Fabius Clements IV, O.D.
• Kayla Cleveland, MS, BCBA
• Clinica Santa Fe
• Coast to Coast Sleep PC
• Coastal Home Care, LLC

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.