Tina Denise Clayton, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0028426 Issued in OH

Practice address

3593 Medina Rd # 181
Medina, OH 44256-8182

Phone

(330) 536-3746

NPI assigned

Aug 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, OR, NC, WA4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boulder Care Provider Group PA

  dba Boulder Care

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  NC, OH, WA

  Medicare reassignment Care Compare group NPD
• Alcove Ventures LLC

  dba Psych360

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
  • NPI 1093191322
  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1144878810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3593 MEDINA LINE RD#181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-990-0420",
            "fax_number": "330-267-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "TINA",
        "middle_name": "DENISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-04-20",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.311016",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN311016",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0028426",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0028426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Marie Clark, OTRL
• Mary Caitlyn Clark
• Taneisha Clark
• Clarkson Optometry Midwest Inc (Clarkson Eyecare)
• Lisa Claus
• Clear Vision Solutions, Inc.
• Stephanie L Clement, P.A.-C
• Cleveland Clinic Children's Hospital for Rehabilitation
• Cleveland Senior Care LLC (at your home care)
• Clinical Apothecaries, Inc. (Clinical Apothecaries)

• Psychiatric/Mental Health Nurse Practitioner in Medina, OH
• Providers in Medina, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.