Organization Active NPI

Clinton a Netherland, MD Apmc

Doing business as Clinton a Netherland, MD

  • Family Medicine Physician
  • Bastrop, LA
National Provider Identifier
1902089246
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINTON A NETHERLAND, MD APMC
Doing business as
Clinton a Netherland, MD
Practice address
510 S Washington St
Bastrop, LA 71220-5033
Phone
(318) 556-3333
Fax
(318) 283-5141
NPI assigned
Dec 10, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

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

Authorized official

Name
Dr. Clinton A Netherland, MD
Title
President
Phone
(318) 556-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

510 S Washington St
Bastrop, LA 71220-5033

Mailing address

510 S Washington St
Bastrop, LA 71220-5033
Phone (318) 556-3333

Other identifiers 1

IdentifierTypeStateIssuer
1104108MedicaidLA

Other names 1

  • CLINTON A NETHERLAND, MD Doing business as

National Provider Directory

National Provider Directory

Locations

427 S Vine St
Bastrop, LA 71220
Phone (318) 556-3333

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1902089246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 S WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712205033",
            "telephone_number": "318-556-3333",
            "fax_number": "318-283-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712205033",
            "telephone_number": "318-556-3333",
            "fax_number": "318-283-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON A NETHERLAND, MD APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "NETHERLAND",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-556-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104108",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINTON A NETHERLAND, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.