Clinton T George, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403059 Issued in NY

Practice address

75 E 3Rd St
Dunkirk, NY 14048-2239

Phone

(716) 363-6050

Fax

(833) 974-1993

NPI assigned

Jul 22, 2020

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Tier Nurse Practitioners in PsychiatryGroup PAC ID 4183068752, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Southern Tier Nurse Practitioners in Psychiatry

  • Adult Mental Health Clinic/Center
  • Lakewood, NY
  • NPI 1225725880
  Medicare reassignment Care Compare group NPD Authorized official
• The Chautauqua Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Dunkirk, NY
  • NPI 1760747521
  NPD

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1821606237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 INSTITUTE ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016628",
            "telephone_number": "716-484-4334",
            "fax_number": "833-974-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E 3RD ST",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482239",
            "telephone_number": "716-363-6050",
            "fax_number": "833-974-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "CLINTON",
        "middle_name": "T",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-22",
        "last_updated": "2024-04-03",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria M Fred
• G&P Gynecare PC
• Alicia L Galecki
• Krista L Garland, LCSW-R
• General Physician, PC
• Katelyn Marie Giguere
• Gunjan Goel, DDS
• Andrea Gonzalez, PHARM.D
• Laura Gonzalez, DMD
• Carole L Goodman, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Dunkirk, NY
• Providers in Dunkirk, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.