Kelly M Clayton, FNP
Individual provider Active NPI Family Nurse Practitioner · Brookings, OR
NPI 1396744769 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1396744769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 200150078NP (OR)
- Practice address
- 446 Oak St
Brookings, OR 97415-9612 - Phone
- (541) 469-7401
- Fax
- (541) 469-7083
- NPI assigned
- Jul 19, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 38
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Corvallis Family Medicine PC
Practice addresses (Care Compare)
2400 NW Kings Blvd
Corvallis, OR 97330-3900
Phone 5417572400108
Hospital & facility affiliations
- Good Samaritan Regional Medical Center
- Samaritan Albany General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050523001084 | OR | Practitioner - Nurse Practitioner | 9638151624 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corvallis Family Medicine PC | Current |
Accepting new patients | |
| Landmark Health of Oregon LLC | Past |
Accepting new patients |
Locations
2400 NW Kings Blvd
Corvallis, OR 97330
Phone (541) 757-2400
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDACAA
- kclayton@bhmc.gwaydirect.com
- kclayton@landmarkhealth-direct.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 200150078NP | OR | Yes |
Addresses
Primary practice location
446 Oak St
Brookings, OR 97415-9612
Mailing address
PO Box 5870
Brookings, OR 97415-0234
Phone (541) 469-7401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228862 | Medicaid | OR |
Other providers in Brookings, OR
- Chetco Anesthesia Services LLC
- Chetco Medical & Aesthetics LLC
- Shirley Garmin Cheung
- Eugene Chickinell
- John Paul Zane Christian
- Coastal Cardiology LLC
- Coastal Diagnostic Testing Group Inc
- Coastal Home Health & Hospice Inc
- Coastal Home Health & Hospice Inc
- Coastal Home Health & Hospice Inc.
All providers in Brookings, OR · Family Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.