Individual provider Active NPI

Dustin Michael Clayton, DPT

  • Physical Medicine & Rehabilitation Physician
  • Columbia, MO
National Provider Identifier
1205357431
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2014028469 Issued in MO
Practice address
1100 Club Village Dr Ste 103
Columbia, MO 65203-4411
Phone
(573) 256-2777
NPI assigned
Jun 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2014028469 MO Primary

Addresses

Primary practice location

1100 Club Village Dr Ste 103
Columbia, MO 65203-4411

Mailing address

1100 Club Village Dr Ste 103
Columbia, MO 65203-4411
Phone (573) 256-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824000138 MO Practitioner - Physical Therapist in Private Practice 7618249764 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Physical Therapy PCGroup PAC ID 9335190339, 27 clinicians

Practice addresses (Care Compare)

1101 W Clay Rd
Lowr Level
Versailles, MO 65084-1177
Phone (877) 870-4976

1800 1St Capitol Dr
Apt 1
Saint Charles, MO 63301-1660
Phone (636) 242-1764

9101 N Ambassador Dr
Kansas City, MO 64154-7295
Phone (816) 631-0847

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014028469MOMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Missouri LLC CurrentSince Nov 18, 2024 Accepting new patients
Empowerme Rehabilitation Missouri LLC CurrentSince Nov 18, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Nov 18, 2024 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Nov 18, 2024 Accepting new patients
NHC Healthcare-Macon LLC Past Accepting new patients

Locations

16255 Chesterfield Pkwy W
Chesterfield, MO 63017
Phone (636) 812-6942

1800 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 255-8094

2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205357431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLUB VILLAGE DR STE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034411",
            "telephone_number": "573-256-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLUB VILLAGE DR STE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034411",
            "telephone_number": "573-256-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "DUSTIN",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2014028469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.