Individual provider Active NPI

Sandra Lynn Clay, FNP-C

  • Family Nurse Practitioner
  • Beckley, WV
National Provider Identifier
1407401789
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
104153 Issued in WV
Practice address
300 Carriage Dr
Beckley, WV 25801-2812
Phone
(304) 255-7878
NPI assigned
Aug 5, 2019
Last updated
May 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104153 WV Primary

Addresses

Primary practice location

300 Carriage Dr
Beckley, WV 25801-2812

Mailing address

302 1/2 Maplewood LN
Beckley, WV 25801-6113
Phone (304) 894-6693

Other practice location 1

236 Warrior Way
New Richmond, WV 24867
Phone (304) 294-7586

Other practice location 2

100 Hresan Blvd
Fayetteville, WV 25840-1333
Phone (304) 574-0770

Other practice location 3

379 Stanaford Rd
Beckley, WV 25801-3141
Phone (304) 253-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303000260 WV Practitioner - Nurse Practitioner 7911334016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh General Hospital LLCGroup PAC ID 6103735154, 27 clinicians

Practice addresses (Care Compare)

1717 Harper Rd
Beckley, WV 25801-3373
Phone (304) 461-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh General Hospital LLC CurrentSince Nov 1, 2022 Accepting new patients
Raleigh General Hospital LLC CurrentSince Nov 1, 2022 Accepting new patients
Lumina Kidney Care Inc CurrentSince Jun 30, 2026 Accepting new patients
Ali Suleiman MD Inc CurrentSince Sep 28, 2024 Accepting new patients
Med Surg Physician Group, Inc. PastSince Oct 15, 2023 Accepting new patients
Raleigh General Hospital Past Accepting new patients

Locations

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

1717 Harper Rd
Ste E
Beckley, WV 25801
Phone (304) 252-4222

1717 Harper Rd
Ste G
Beckley, WV 25801
Phone (304) 461-3700

300 Carriage Dr
Beckley, WV 25801
Phone (304) 255-7878

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: sandra.clay.2@20211.direct.athenahealth.com
  • Direct secure messaging: sandra.clay@wvafn.hcadirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1407401789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 1/2 MAPLEWOOD LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016113",
            "telephone_number": "304-894-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CARRIAGE DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012812",
            "telephone_number": "304-255-7878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "236 Warrior Way",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WV",
            "postal_code": "24867",
            "country_code": "US",
            "telephone_number": "304-294-7586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hresan Blvd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "WV",
            "postal_code": "258401333",
            "country_code": "US",
            "telephone_number": "304-574-0770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "379 Stanaford Rd",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258013141",
            "country_code": "US",
            "telephone_number": "304-253-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAY",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.