David Lee Clayton, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01024951 Issued in IN

Practice address

621 Memorial Dr
Suite 624
South Bend, IN 46601-1063

Phone

(574) 282-2708

Fax

(574) 282-1044

NPI assigned

Nov 10, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• North Central Neurology, LLC

  • Neurology Physician
  • South Bend, IN
  • NPI 1134262595
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1912988460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "address_2": "SUITE 624",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-282-2708",
            "fax_number": "574-282-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MEMORIAL DR",
            "address_2": "SUITE 624",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011063",
            "telephone_number": "574-282-2708",
            "fax_number": "574-282-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01024951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/ANTHEM",
            "identifier": "000000084082",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sylvan E Clarke, M.D.
• Clarkson Mobility 24/7/365 LLC.
• Robert W Clausen, MD
• Clay Civil Township
• Clay Township Clinic LLC
• Robert E. Clemency Jr., M.D.
• Alexia Renee Clements
• Ivan Ross Clements
• Elaine Clemons
• Samantha Clemons

• Family Medicine Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.