CLAYTOR MEMORIAL CLINIC (NPI# 1720453905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720453905 |
| Entity Type | Organization |
| Organization Name | CLAYTOR MEMORIAL CLINIC |
| Practice Address |
1625 Franklin St Rocky Mount VA 24151-6390 |
| Practice Telephone | 8445439362 |
| Mailing Telephone | 8445439362 |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |
| Authorized Official Name | DR. RICHARD LAMONT CLAYTOR JR. (OWNER) |
| Authorized Official Telephone | 5405986321 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
0101055727 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1376633610 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Claytor Memorial Clinic LLC | 1127 2nd St Sw, Roanoke, Virginia 24016 |
| Street Address |
1625 FRANKLIN ST |
| City | ROCKY MOUNT |
| State | VA |
| Zip Code | 24151-6390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376633610 | Richard Lamont Claytor Jr. | Psychiatry & Neurology | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2006-10-16 |
| 1689180200 | Claytor Clinic, Inc. | Psychiatry & Neurology | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2017-12-19 |
| 1720445992 | Monica Lynn Wiltjer | Physician Assistant | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2016-01-19 |
| 1770813636 | The Center for Christian Counseling | Community/Behavioral Health | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2009-12-28 |
| 1548599590 | Darrell Hunley | Counselor | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2009-12-21 |
| 1023288024 | Avery K Flory | Counselor | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2008-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093987 | Youth Connect of Virginia, Inc. | Counselor | 370 Tanyard Rd, Rocky Mount, VA 24151 | 2018-05-15 |
| 1568975696 | Kathleen Conway | Speech-Language Pathologist | 25 Bernard Road, Rocky Mount, VA 24151 | 2017-11-11 |
| 1639581960 | Kylie Morris | Family Medicine | 390 S Main St Ste 201, Rocky Mount, VA 24151 | 2014-05-21 |
| 1366791972 | Free Clinic of Franklin County | Clinic/Center | 1171 Franklin Street, Rocky Mount, VA 24151 | 2012-08-29 |
| 1760786115 | Rick H Orange | Pharmacist | 200 Parkside Ln, Rocky Mount, VA 24151 | 2010-12-28 |
| 1952455875 | Rocky Mount Chiropractic Inc | Chiropractor | 546 Pell Ave, Rocky Mount, VA 24151 | 2007-01-22 |
| 1912065277 | Becker Clinic Ltd | Chiropractor | 1533 Franklin Street, Rocky Mount, VA 24151 | 2006-12-05 |
| 1952476244 | Accident and Injury Chiropractic PC | Chiropractor | Accident and Injury Chiropractic PC, 20385 Virgil H Goode Hwy Ste 1, Rocky Mount, VA 24151 | 2006-11-21 |
| 1548352602 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 365 Pell Ave, Rocky Mount, VA 24151 | 2006-09-28 |
| 1073611422 | Cathy Zoe Ford | Dentist | 490 S Main Street, Suite 201, Rocky Mount, VA 24151 | 2006-09-20 |
| Find all providers in zip 24151 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689180200 | Claytor Clinic, Inc. | Psychiatry & Neurology | 1625 Franklin St, Rocky Mount, VA 24151-6390 | 2017-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902248073 | Tanvir Iqbal | Psychiatry & Neurology | 201 S Main St Ste 3400, Danville, VA 24541-2932 | 2013-07-18 |
| 1821364043 | Michael Kubelik Heck | Psychiatry & Neurology | 691 Berkmar Cir, Charlottesville, VA 22901-1464 | 2012-04-02 |
| 1831403864 | Neel Nene | Psychiatry & Neurology | 801 N Quincy St Ste 601, Arlington, VA 22203-1729 | 2010-08-02 |
| 1295048684 | My Psychiatrist, Plc | Psychiatry & Neurology | 12359 Sunrise Valley Dr Ste 320, Herndon, VA 20191-3463 | 2010-07-14 |
| 1023257979 | Kevin Michael Williams | Psychiatry & Neurology | 3737 Seminary Rd, Alexandria, VA 22304-5202 | 2009-02-17 |
| 1881854982 | John Paul Steg | Psychiatry & Neurology | 6760 Old Mclean Village Dr, Mc Lean, VA 22101-3906 | 2008-06-11 |
| 1336343516 | Nelson Lugo | Psychiatry & Neurology | 43330 Junction Plz Ste 160, Pmb 108, Ashburn, VA 20147-3408 | 2007-06-12 |
| 1598973471 | Charles E Hall Iv | Psychiatry & Neurology | 100 Boulders Pkwy, Suite 202, Richmond, VA 23225 | 2007-05-21 |
| 1699983692 | Heather Kilbride Henig | Psychiatry & Neurology | 11490 Commerce Park Dr Ste 420, Reston, VA 20191 | 2007-05-21 |
| 1104942754 | William Louis Licamele | Psychiatry & Neurology | 6760 Old Mclean Village Dr., Mclean, VA 22101-3906 | 2007-03-22 |
| Find all providers with the same taxonomy | ||||
| City | ROCKY MOUNT |
| Zip Code | 24151 |
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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.