NPIMap

Individual provider Active NPI

Heidi A Clay, MD

  • Geriatric Psychiatry Physician
  • Puyallup, WA
National Provider Identifier
1043223472
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
0101048492 Issued in VA
Practice address
4227 S Meridian # C231
Puyallup, WA 98373-3603
Phone
(253) 582-8440
NPI assigned
Aug 15, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101048492 VA
Geriatric Psychiatry Physician 2084P0805X 0101048492 VA Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 0101048492 VA

Addresses

Primary practice location

4227 S Meridian # C231
Puyallup, WA 98373-3603

Mailing address

4227 S Meridian # C231
Puyallup, WA 98373-3603

Other identifiers 4

IdentifierTypeStateIssuer
198038OtherVABLUE CROSS
347359OtherVAANTHEM
198039OtherVABLUE CROSS
004945298MedicaidVA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101048492VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Rogers Community Services PastSince Jan 1, 1992 Accepting new patients
Life Recovery LLC Psychiatry Past Accepting new patients
New River Valley Community Services Past Accepting new patients
New River Valley Community Services Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1043223472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 S MERIDIAN # C231",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 S MERIDIAN # C231",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733603",
            "telephone_number": "253-582-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "HEIDI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101048492",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "VA",
            "license": "0101048492",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "VA",
            "license": "0101048492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "198038",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "347359",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "198039",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945298",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.