Clarence Mayo

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

1586 Issued in VA

Practice address

153 Blackheath
Williamsburg, VA 23188-7482

Phone

(757) 209-1060

Fax

(757) 345-0125

NPI assigned

Apr 9, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Colorful Beginnings Services LLC

  • Developmentally Disabled Services Day Training Agency
  • Suffolk, VA
  • NPI 1073246740
  NPD Authorized official
• Faith Hope Care Provider

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Williamsburg, VA
  • NPI 1477965838
  NPD (past) Authorized official

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1962821611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BLACKHEATH",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231887482",
            "telephone_number": "757-209-1060",
            "fax_number": "757-345-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BLACKHEATH",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231887482",
            "telephone_number": "757-209-1060",
            "fax_number": "757-345-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "CLARENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "VA",
            "license": "1586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dellyn Renee Matthew
• Tayler Matthews, LSATP, LADACII, CSAC
• Ana M Maya Adkins, DMD
• Bruce Mayer, MD
• Patricia F. N. Mayes, MD
• Shanika K Mayo
• Kaitlin Marie McCaffrey- Leyden
• Catherine Anne McCann-Shelton, PA
• John J McCarthy III, MD
• Kamila McCaskill

• Point of Service in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Point of Service in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.