Active NPI
Olivia Grace Clay, ATC
- Athletic Trainer
- Meridian, MS
National Provider Identifier
1114607983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-1096
- Practice address
- 1800 12TH St
Meridian, MS 39301-4158 - Phone
- (601) 483-0011
- NPI assigned
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-1096 | MS | Primary |
Addresses
Primary practice location
1800 12TH St
Meridian, MS 39301-4158
Mailing address
57 Harmony Baptist Church Rd
Louisville, MS 39339-8985
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT-1096 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1114607983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 HARMONY BAPTIST CHURCH RD",
"city": "LOUISVILLE",
"state": "MS",
"postal_code": "393398985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 12TH ST",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393014158",
"telephone_number": "601-483-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "OLIVIA",
"middle_name": "GRACE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-18",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT-1096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.