NPIMap

Individual provider Active NPI

Clifford H Mault, D.O.

  • Internal Medicine Physician
  • Sylva, NC
National Provider Identifier
1902870736
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200300173 Issued in NC
Practice address
12 Grindstaff Cove Rd
Sylva, NC 28779
Phone
(828) 586-0807
Fax
(828) 586-8490
NPI assigned
Feb 16, 2006
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200300173 NC Primary

Addresses

Primary practice location

12 Grindstaff Cove Rd
Sylva, NC 28779

Mailing address

PO Box 1836
Sylva, NC 28779
Phone (828) 586-0807

Other identifiers 2

IdentifierTypeStateIssuer
5900095MedicaidNC
138XCOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071012000721 NC Practitioner - Internal Medicine 3274629738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Grindstaff Cove Rd
Sylva, NC 28779-2535
Phone (828) 586-0807

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clifford H. Mault, D.O., P.a. Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

Locations

12 Grindstaff Cove Rd
Sylva, NC 28779
Phone (828) 586-0807

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 6

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1902870736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1836",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "28779",
            "telephone_number": "828-586-0807",
            "fax_number": "828-586-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 GRINDSTAFF COVE RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "28779",
            "telephone_number": "828-586-0807",
            "fax_number": "828-586-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAULT",
        "first_name": "CLIFFORD",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200300173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900095",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "138XC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

Verify at the official NPI Registry.