Clarkholder Clinic PA

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

416 Issued in GA

Legal business name

CLARKHOLDER CLINIC PA

Practice address

303 Smith St
Lagrange, GA 30240-2745

Phone

(706) 882-8831

Fax

(706) 812-4079

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Keeter

Title

Cbo Manager

Phone

(706) 812-4206

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962427971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SMITH ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402745",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SMITH ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402745",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKHOLDER CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEETER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CBO MANAGER",
        "authorized_official_telephone_number": "706-812-4206"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Childrens Clinic of Lagrange, LLC
• Drake Childress, DMD
• George W Childress, D.M.D.
• Chiropractic Soulution, LLC
• Clark-Holder Clinic, P.a.
• Joni Lynn Clay, NP
• Camille Clemons
• Valerie Kuecker Cleveland, LPC
• Paige Michelle Clifton, NP
• Monique Shevelle Clinton-Graves, MSW

• Health Maintenance Organization in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Health Maintenance Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.