Charlie Clay III, MBA

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

281 Nixon Street
Biloxi, MS 39530

Phone

(228) 209-2906

NPI assigned

Mar 14, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1487355707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 NIXON STREET",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39530",
            "telephone_number": "228-209-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 NIXON STREET",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39530",
            "telephone_number": "228-209-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "CHARLIE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristian Delane Clark, LCSW
• Linda Clark, PHARM D
• Monica Clark
• Paul Frasier Clark III, LAC
• Victoria Wilson Clark, MD
• Kasey Clayton
• CLC of Biloxi, LLC
• Clear Blue Counseling, LLC
• Clearview Psychiatry LLC
• Carla Cleary

• Customized Equipment (DME) in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Customized Equipment (DME) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.