Clayton Thomas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2058 Issued in KY

Practice address

402 Cumberland Ave
Williamsburg, KY 40769-1238

Phone

(606) 549-2656

Fax

(606) 549-2855

NPI assigned

Sep 22, 2015

Last updated

May 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dayspring Health IncGroup PAC ID 7214990746, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Dayspring Health Inc

  dba Clear Fork Clinic

  • Federally Qualified Health Center (FQHC)
  • Clairfield, TN
  • NPI 1013049469

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Dayspring Health Inc

  dba Dayspring Dental

  • Federally Qualified Health Center (FQHC)
  • Williamsburg, KY
  • NPI 1871631804
  Medicare reassignment
• Dayspring Health, Inc.

  dba Dayspring Regional Health Center

  • Federally Qualified Health Center (FQHC)
  • Williamsburg, KY
  • NPI 1538867551
  NPD
• Dayspring Health, Inc.

  dba Dayspring Jellico

  • Federally Qualified Health Center (FQHC)
  • Jellico, TN
  • NPI 1023022084

  Physician Assistant

  NPD

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1487023248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377620030",
            "telephone_number": "423-784-5771",
            "fax_number": "423-455-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 CUMBERLAND AVE",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691238",
            "telephone_number": "606-549-2656",
            "fax_number": "606-549-2855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5663 Highway 90",
            "address_purpose": "LOCATION",
            "city": "Clairfield",
            "state": "TN",
            "postal_code": "377153632",
            "country_code": "US",
            "telephone_number": "423-784-5771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Sunset Trl",
            "address_purpose": "LOCATION",
            "city": "Jellico",
            "state": "TN",
            "postal_code": "377622343",
            "country_code": "US",
            "telephone_number": "423-784-5771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CLAYTON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-22",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA3108",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100405120",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026771",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2058",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3108",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brina Kylene Strebeck, ATC
• Sibyl Lynne Stricklin
• Travis Jordan Sulfridge, DVM
• Ciera D Swords
• Matthew Testa, OD
• Lesley Anne Tipton, PA-C
• Eddie C Towles, D.M.D.
• University of the Cumberlands
• Jeannie Marie Vorbeck, MS, OTR/L
• Jennifer Lynn Wake-Floyd, MS, ATC

• Physician Assistant in Williamsburg, KY
• Providers in Williamsburg, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.