Active NPI
Beverly Clay
- Health Educator
- Brandon, MS
National Provider Identifier
1023502804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 220 Old Oak Cir
Brandon, MS 39042-2611 - Phone
- (601) 616-2704
- Fax
- (769) 218-0011
- NPI assigned
- Jun 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Respite Care | 385H00000X | MS | ||
| Health Educator | 174H00000X | MS | Primary | |
| Personal Care Attendant | 3747P1801X | MS |
Addresses
Primary practice location
220 Old Oak Cir
Brandon, MS 39042-2611
Mailing address
PO Box 1641
Brandon, MS 39043-1641
Phone (601) 616-2704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674345600000",
"number": "1023502804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1641",
"city": "BRANDON",
"state": "MS",
"postal_code": "390431641",
"telephone_number": "601-616-2704",
"fax_number": "769-235-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 OLD OAK CIR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390422611",
"telephone_number": "601-616-2704",
"fax_number": "769-218-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "BEVERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-15",
"last_updated": "2023-01-22",
"certification_date": "2021-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "MS",
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "MS",
"license": null,
"primary": true
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "MS",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.