Clayton Joe Carson
Individual provider Active NPI Family Nurse Practitioner · Piedmont, MO
NPI 1003540501 · NPPES record last updated Jul 12, 2022
Key facts
- NPI
- 1003540501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2022026858 (MO)
- Practice address
- 420 Piedmont Ave
Piedmont, MO 63957-1024 - Phone
- (573) 223-4233
- NPI assigned
- Jul 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 20
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Francis Medical Center
Practice addresses (Care Compare)
420 Piedmont Ave
Piedmont, MO 63957-1024
Phone (573) 223-4233
Hospital & facility affiliations
- Centerwell Home Health
- Saint Francis Medical Center
- Poplar Bluff Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.07 of 100
- Quality
- 85.4
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220801002450 | MO | Practitioner - Nurse Practitioner | 5799167144 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022026858 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Current |
Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Family | Current |
Accepting new patients |
| Saint Francis Medical Center | Past | Accepting new patients |
Locations
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
420 Piedmont Ave
Piedmont, MO 63957
Phone (573) 223-2526
Interoperability endpoints
- ccarson101146@surescripts.sfmc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2022026858 | MO | Yes |
Addresses
Primary practice location
420 Piedmont Ave
Piedmont, MO 63957-1024
Mailing address
724 W Green Hill St
Piedmont, MO 63957-1100
Other providers in Piedmont, MO
- Braden Bremmon
- Tara Kathryn Burleson
- Alexandra D Burns
- Nicole Marie Burse
- Theron Burse
- Clark'S Mountain Management, Corp
- Clearwater Ambulance District
- Clearwater Health Resources Inc
- Clearwater Health Resources Inc
- Clearwater R-1 School District
All providers in Piedmont, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.