Individual provider Active NPI

Samuel Gray McClatchy, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fayetteville, AR
National Provider Identifier
1356796684
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
E-15633 Issued in AR
Practice address
3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone
(479) 521-2752
Fax
(479) 521-4603
NPI assigned
Apr 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 28373 MS
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X E-15633 AR Primary

Addresses

Primary practice location

3317 N Wimberly Dr
Fayetteville, AR 72703-4056

Mailing address

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address samuel.mcclatchy.1@18403.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220729002022 AR Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 8527358910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
University of Arkansas College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fands Physical Therapy, IncGroup PAC ID 7810898459, 217 clinicians
Ozark Orthopaedics, P.a.Group PAC ID 2860477189, 57 clinicians

Practice addresses (Care Compare)

1414 Hwy 71 N
Alma, AR 72921-4723
Phone (479) 632-0321

3317 N Wimberly Dr
Fayetteville, AR 72703-4056
Phone (479) 521-2752

Hospital & facility affiliations

  • Washington Regional Medical Center Hospital, Fayetteville, AR, CCN 040004

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)11
Upper limb (arm) arthroscopy (minimally invasive joint repair)83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28373MSMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Orthopaedics, P.a. Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients
Ozark Orthopaedics, PA Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients

Locations

3352 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 521-1427

3317 N Wimberly Dr
Fayetteville, AR 72703
Phone (479) 521-2752

3317 N Wimberly Dr
Fl 2
Fayetteville, AR 72703
Phone (479) 587-3117

Interoperability endpoints

  • Direct secure messaging: smcclatchy23154@washingtonregional.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/18403/brand/1/csg/1/fhir/r4
  • Direct secure messaging: samuel.mcclatchy.1@18403.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1461369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1356796684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 N WIMBERLY DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034056",
            "telephone_number": "479-521-2752",
            "fax_number": "479-521-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLATCHY",
        "first_name": "SAMUEL",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-23",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "28373",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AR",
            "license": "E-15633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.mcclatchy.1@18403.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3317 N Wimberly Dr",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727034056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.