Clayton Franklin Fuqua, MD

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

0101267570 Issued in VA

Practice address

7050 Air Depot Blvd BLDG 1094
Tinker Afb, OK 73145-8716

Phone

(405) 582-6615

NPI assigned

Jun 18, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)
• NH Camp Pendleton

  • Military General Acute Care Hospital
  • Camp Pendleton, CA
  • NPI 1386604387
  NPD (past)

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1487148177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-582-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-582-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "CLAYTON",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101267570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Leonard Ettel III, DO
• Audra Feisal, LCSW
• Misty Spring Evelyn Foley-McKenna, LCSW
• Shaylee Jade Fouts, MED, ATC, LAT, PES
• Stacey Anne Frazier, MD
• Jason Garner, MD
• Ramiro Alexander Garrido, PT
• Mark Gosnell Jr., IDMT
• Sarah K Green, PSY.D.
• Kristin Nicole Greer, MD

• Military Health Care Provider in Tinker Afb, OK
• Providers in Tinker Afb, OK by specialty
• Military Health Care Provider in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.