Clay Warren

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT3927 Issued in OK

Practice address

1001 N Country Club Rd
Ada, OK 74820-2847

Phone

(580) 421-4570

Fax

(580) 421-6283

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Rehab LLC

  dba Prohab Therapy Specialists

  • Physical Therapist
  • Madill, OK
  • NPI 1447480082
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1023198165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N COUNTRY CLUB RD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202847",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "CLAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OK",
            "license": "PT3927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK LICENSE",
            "identifier": "PT3927",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connie Leann Walton, RN, LMT
• Larson Dean Walton, BA,AA,AA,AA,AA,AA,AA
• Tarra Ward
• Paul Franklin Warlick, D.O.
• Kristen Warnock, D.O.
• Jaycee Warren
• Mandy Lynne Waters, APRN-CNP
• Christyn Kay Wear, MSW
• Jana Jean Webb, LPC
• Nathan Wade Weeks, BA

• Physical Medicine & Rehabilitation Physician in Ada, OK
• Providers in Ada, OK by specialty
• Physical Medicine & Rehabilitation Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.