MR. CARLTON WAYNE MCCLELLAN (NPI# 1477673622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477673622 |
| Entity Type | Individual |
| Full Name | MR. CARLTON WAYNE MCCLELLAN |
| Credential | PA-C |
| Practice Address |
196 Thomas Johnson Dr Ste 215 Frederick MD 21702-4397 |
| Practice Telephone | 3016689988 |
| Practice Fax Number | 3016689977 |
| Mailing Telephone | 3016689988 |
| Mailing Fax Number | 3016689977 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2010-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C002852 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
196 THOMAS JOHNSON DR STE 215 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283579 | Sallyann Mccarthy | Registered Nurse | 196 Thomas Johnson Dr, Suite 120-b, Frederick, MD 21702-4397 | 2005-08-29 |
| 1962036624 | Cleopatra Kulasi | Family Medicine | 196 Thomas Johnson Dr, Frederick, MD 21702-4397 | 2020-03-02 |
| 1922510056 | Paola Haros | Physician Assistant | 196 Thomas Johnson Dr, Frederick, MD 21702-4397 | 2017-10-30 |
| 1912441890 | Heather Wilber | Physician Assistant | 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4397 | 2016-12-12 |
| 1952858771 | Tania Thornton | Nurse Practitioner | 196 Thomas Johnson Dr, Suite 215, Frederick, MD 21702-4397 | 2016-09-09 |
| 1891150744 | Dental Associates of Frederick, LLC | Dentist | 196 Thomas Johnson Dr, Suite 235, Frederick, MD 21702-4397 | 2015-12-18 |
| 1194119818 | Corey Amber Ward | Nurse Practitioner | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4397 | 2015-03-19 |
| 1841698925 | Alexander King | Acupuncturist | 196 Thomas Johnson Dr, 125, Frederick, MD 21702-4397 | 2014-12-05 |
| 1104237858 | Dr. E.j. Stringer, D.m.d., P.a. | Dentist | 196 Thomas Johnson Dr, Suite 200, Frederick, MD 21702-4397 | 2014-05-15 |
| 1720326002 | Dr. Eunjoo Song Stringer Dmd | Dentist | 196 Thomas Johnson Dr, Suite 200, Frederick, MD 21702-4397 | 2013-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801164066 | Atekelt Yilma Tadese | Physician Assistant | 46-b Thomas Johnson Drive, Suite 200, Frederick, MD 21702 | 2011-12-02 |
| 1619121472 | Barbara S. Rebele | Physician Assistant | 22 S Market St, Suite 6d, Frederick, MD 21701-5570 | 2008-11-06 |
| 1790954253 | Robert Paul Cathor | Physician Assistant | 56 Thomas Johnson Drive, Ste 110, Frederick, MD 21702-4599 | 2008-02-28 |
| 1598946006 | Justina A Bennett | Physician Assistant | 85 Thomas Johnson Ct, Suite C, Internal Medicine Specialists of Frederick, Frederick, MD 21702 | 2007-11-27 |
| 1104809342 | Tara Carson Jernejcic | Physician Assistant | 100 South Market Street, Frederick Community Action Agency, Frederick, MD 21701 | 2005-11-22 |
| 1376001214 | Lewis Edel Bertus | Physician Assistant | 610 Solarex Ct, Frederick, MD 21703-8624 | 2019-03-11 |
| 1922510056 | Paola Haros | Physician Assistant | 196 Thomas Johnson Dr, Frederick, MD 21702-4397 | 2017-10-30 |
| 1861867459 | Kelly Murray | Physician Assistant | 915 Toll House Ave Ste 103, Frederick, MD 21701-5911 | 2015-12-08 |
| 1295142388 | Rebecca Alyson Leonard | Physician Assistant | 63 Thomas Johnson Dr, Suite E, Frederick, MD 21702-4384 | 2014-07-21 |
| 1912332123 | Brittany Leigh Henry | Physician Assistant | 87 Thomas Johnson Dr Ste 101, Frederick, MD 21702-4427 | 2013-09-06 |
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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.