Individual provider Active NPI

Wade Hampton Clay, D.D.S.

  • Periodontics
  • Midland, TX
National Provider Identifier
1497819627
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12551 Issued in TX
Practice address
4214 Andrews Hwy Ste 302
Midland, TX 79703-4864
Phone
(432) 687-1551
Fax
(432) 687-1177
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 12551 TX Primary

Addresses

Primary practice location

4214 Andrews Hwy Ste 302
Midland, TX 79703-4864

Mailing address

4214 Andrews Hwy Ste 302
Midland, TX 79703-4864
Phone (432) 687-1551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12551TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497819627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 302",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034864",
            "telephone_number": "432-687-1551",
            "fax_number": "432-687-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 302",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034864",
            "telephone_number": "432-687-1551",
            "fax_number": "432-687-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "WADE",
        "middle_name": "HAMPTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "12551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.