Active NPI
Kevin R Clay, MD
- Family Medicine Physician
- Stanwood, WA
National Provider Identifier
1346216561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34133
- Practice address
- 7205 265TH St NW
Stanwood, WA 98292-6221 - Phone
- (360) 629-1504
- NPI assigned
- Feb 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34133 | WA | Primary |
Addresses
Primary practice location
7205 265TH St NW
Stanwood, WA 98292-6221
Mailing address
PO Box 5127
Everett, WA 98206-5127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008135 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34133 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1346216561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7205 265TH ST NW",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982926221",
"telephone_number": "360-629-1504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "KEVIN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "34133",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008135",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stanwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.