John Bradley Clifton

Family NPI1427515915

Summary

About

John Bradley Clifton specialises in Family. He currently works in Louisiana.

Provider Details

NPI Number 1427515915
Provider Name John Bradley Clifton
Credential
Specialization Family
Medical School Name Other
Graduation Year 2015
Gender M
Entity Type Individual
PAC ID by PECOS 5991044810
Professional Enrollment ID I20190311001725
Enumeration Date 02/21/2019
Last Update Date 02/21/2019

Contact Details

Business Practice address 104 VERONA STREET, Newellton,
71357 Louisiana View on Google Map
Business Practice phone 318-467-9949
Business Practice fax 318-467-2093
Mailing address 2106 LOOP RD, Winnsboro,
71295-3344 Louisiana View on Google Map
Other phone 318-412-5265
Other fax 318-435-3842
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for John Bradley Clifton Update NPI

Hospital Affilitation

Practices in Newellton

Newellton, Louisiana

Education & Training

Other

Family, 2015

Group Affiliation

Organization Name PECOS PAC ID Members
Coastal Urgent Care, Llc 8729138896 21
Hulin Urgent Care Services, Llc 6800051285 106
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Primary Taxonomy
Taxonomy
License No.
203909 (Louisiana)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1427515915
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor N
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Clifton
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name John
The first name of the provider, if the provider is an individual.
Provider Credential Text APRN
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 2106 LOOP RD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Winnsboro
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Louisiana
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 71295-3344
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 318-412-5265
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 318-435-3842
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 104 VERONA STREET
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Newellton
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Louisiana
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 71357
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 318-467-9949
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 318-467-2093
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 02/21/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 02/21/2019
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 363LF0000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 Definition to come...
Healthcare Provider Taxonomy #1
Provider License Number 1 203909
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 LA
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.