MR. CLAYTON PHILLIP GATTERDAM IV (NPI# 1174890172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174890172 |
Entity Type | Individual |
Full Name | MR. CLAYTON PHILLIP GATTERDAM IV |
Credential | PA-C |
Practice Address |
3205 Summit Square Suite 100 Lexington KY 40509 |
Practice Telephone | 8593359041 |
Mailing Telephone | 8593359041 |
Enumeration Date | 2011-11-19 |
Last Update Date | 2011-11-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
TC065 | KY | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3205 SUMMIT SQUARE SUITE 100 |
City | LEXINGTON |
State | KY |
Zip Code | 40509 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902453640 | Grace T. Hallak | Counselor | 513 Darby Creek Rd, Lexington, KY 40509 | 2019-08-19 |
1932755774 | Lexington-fayette Urban-county Health Department | Public Health or Welfare | 4801 Athens Boonesboro Rd, Lexington, KY 40509 | 2019-08-16 |
1497308266 | Discover You Counseling LLC | Social Worker | 513 Darby Creek Drive, Unit 56 D, Lexington, KY 40509 | 2019-07-22 |
1407323611 | Trevor Douglas Mchardy | Physician Assistant | 101 North Eagle Creek Drive, Lexington, KY 40509 | 2018-10-25 |
1114413184 | Megan Medrano | Dietitian, Registered | 163 Old Todds Rd Ste 115, Lexington, KY 40509 | 2018-07-02 |
1750884292 | Active Medical LLC | Durable Medical Equipment & Medical Supplies | 3470 Blazer Pkwy Ste 350, Lexington, KY 40509 | 2018-03-12 |
1699273599 | Frederick Douglas High School | Public Health or Welfare | 2000 Winchester Rd, Lexington, KY 40509 | 2018-01-25 |
1710409370 | Sleep Identity Pllc | Clinic/Center | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2017-07-14 |
1164956397 | Danielle Anderson | Family Medicine | 24 Fountain Court, Suite 225, Lexington, KY 40509 | 2017-04-14 |
1356891782 | Dawn Jones | Physician Assistant | 101 N Eagle Creek Dr, Ste 120, Lexington, KY 40509 | 2016-10-10 |
Find all providers in zip 40509 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306118617 | Lb Health Psc | Physician Assistant | 1904 Nicholasville Rd, Lexington, KY 40503-2025 | 2012-02-01 |
1134237340 | Rebecca Ward Hogsten | Physician Assistant | 4071 Tates Creek Centre Dr Ste 100, Lexington, KY 40517-3062 | 2006-08-28 |
1427003524 | David Wendell Moore | Physician Assistant | 101 Prosperous Pl Ste 300, Lexington, KY 40509-1836 | 2006-05-24 |
1376514760 | Kerri F Stillwell | Physician Assistant | 110 Houston Street, Lexington, VA 24450-0912 | 2006-02-01 |
1215914684 | Philip Harold Lafleur | Physician Assistant | 1055 Dove Run Road, Lexington, KY 40502 | 2005-12-28 |
1083690317 | Jana Sue Cuddy | Physician Assistant | 1055 Dove Run Rd, Lexington, KY 40502 | 2005-12-19 |
1942852157 | Anna Gayle Scott | Physician Assistant | 989 Governors Ln Ste 220, Lexington, KY 40513-1175 | 2019-07-09 |
1609333582 | Hannah Leigh Burford | Physician Assistant | 1401 Harrodsburg Rd Ste C305, Lexington, KY 40504-3771 | 2019-02-27 |
1881177186 | Sarah Kruyer | Physician Assistant | 250 Hospital Dr, Lexington, NC 27292-6792 | 2018-09-12 |
1376073106 | Megan Eileen Smith | Physician Assistant | 250 Hospital Dr, Lexington, NC 27292-6792 | 2017-06-14 |
Find all providers in LEXINGTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.