Active NPI
Eugene Clay
- Registered Nurse
- Yazoo City, MS
National Provider Identifier
1558951715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R898641
- Practice address
- 800 E Fifteenth St
Yazoo City, MS 39194-7625 - Phone
- (662) 751-8580
- NPI assigned
- Jan 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R898641 | MS | Primary |
Addresses
Primary practice location
800 E Fifteenth St
Yazoo City, MS 39194-7625
Mailing address
216 N Jackson St
Canton, MS 39046-3918
Phone (601) 850-3771
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.cvshealth.com | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R898641 | MS | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi CVS Pharmacy LLC | Past | Accepting new patients | |
| Mississippi CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1558951715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 N JACKSON ST",
"city": "CANTON",
"state": "MS",
"postal_code": "390463918",
"telephone_number": "601-850-3771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E FIFTEENTH ST",
"city": "YAZOO CITY",
"state": "MS",
"postal_code": "391947625",
"telephone_number": "662-751-8580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "EUGENE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MS",
"license": "R898641",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.cvshealth.com",
"affiliation": "N",
"endpointDescription": "CVS Health is an American healthcare company that owns CVS Pharmacy, a retail pharmacy chain. The company's headquarter is in Woonsocket, Rhode Island.",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "800 E Fifteenth St",
"city": "Yazoo City",
"state": "MS",
"country_code": "US",
"postal_code": "391947625",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Yazoo City, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.