Individual provider Active NPI

Natalie Lauren Clericuzio, MD

  • Obstetrics & Gynecology Physician
  • Johns Creek, GA
National Provider Identifier
1821550724
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
96000 Issued in GA
Practice address
10692 Medlock Bridge Rd
Johns Creek, GA 30097-1890
Phone
(404) 446-2492
NPI assigned
Apr 1, 2019
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 96000 GA Primary

Addresses

Primary practice location

10692 Medlock Bridge Rd
Johns Creek, GA 30097-1890

Mailing address

10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497
Phone (404) 446-2492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20260420003031 MS Practitioner - Obstetrics/Gynecology 1759612476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at San Antonio, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
North Perimeter Anesthesia LLC PastSince Jul 9, 2023 Accepting new patients
University Physicians, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nclericuzio116312@ummc.direct-ci.com

Organizations & group practices 3

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.

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1821550724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10692 MEDLOCK BRIDGE RD STE 100A",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978497",
            "telephone_number": "404-446-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10692 MEDLOCK BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971890",
            "telephone_number": "404-446-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERICUZIO",
        "first_name": "NATALIE",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "96000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.