NPIMap

Individual provider Active NPI

Brian Marcus Clay, NP-BC

  • Adult Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1295463784
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024184790 Issued in VA
Practice address
240 Mustang TRL Ste 1
Virginia Beach, VA 23452-7516
Phone
(757) 821-2088
Fax
(757) 821-2081
NPI assigned
Aug 11, 2022
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024184790 VA Primary

Addresses

Primary practice location

240 Mustang TRL Ste 1
Virginia Beach, VA 23452-7516

Mailing address

240 Mustang TRL Ste 1
Virginia Beach, VA 23452-7516
Phone (757) 821-2088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014000463 VA Practitioner - Nurse Practitioner 6305212408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4421 Virginia Beach Blvd
VA Beach, VA 23462-3114

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024184790VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Vascular Institute CurrentSince Sep 29, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Dec 1, 2024 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Dec 1, 2024 Accepting new patients

Locations

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 401
Newport News, VA 23606
Phone (757) 232-8764

150 Burnetts Way
Ste 200
Suffolk, VA 23434
Phone (757) 539-7824

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1295463784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MUSTANG TRL STE 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527516",
            "telephone_number": "757-821-2088",
            "fax_number": "757-821-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MUSTANG TRL STE 1",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527516",
            "telephone_number": "757-821-2088",
            "fax_number": "757-821-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "BRIAN",
        "middle_name": "MARCUS",
        "name_prefix": "Mr.",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024184790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.