NPIMap

Individual provider Active NPI

Cheryl A Clay, M.D.

  • Pediatrics Physician
  • Ontario, OH
National Provider Identifier
1093926693
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.091205 Issued in OH
Practice address
715 Richland Mall
Ontario, OH 44906-3802
Phone
(419) 756-8511
NPI assigned
May 24, 2007
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.091205 OH Primary

Addresses

Primary practice location

715 Richland Mall
Ontario, OH 44906-3802

Mailing address

700 N Columbus St
Crestline, OH 44827-1455
Phone (419) 468-0522

Other identifiers 1

IdentifierTypeStateIssuer
2836720MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cclay490007@direct.osumc.edu

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
35.091205OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Ohio Family Care Center, Inc Past Accepting new patients
Avita Ontario Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2586/brand/1/csg/1/fhir/r4
  • FHIR API: https://ihismufhir.osumc.edu/fhir-prd/api/FHIR/R4/
  • Direct secure messaging: cclay490007@direct.osumc.edu

Organizations & group practices 2

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1093926693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455",
            "telephone_number": "419-468-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 RICHLAND MALL",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063802",
            "telephone_number": "419-756-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "CHERYL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.091205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2836720",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cclay490007@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "715 Richland Mall",
            "city": "Ontario",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449063802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.