Active NPI
Angela L Clay, OTR
- Occupational Therapist
- Brandon, MS
National Provider Identifier
1609178680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 2322
- Practice address
- 718 Whippoorwill Dr
Brandon, MS 39047-7375 - Phone
- (601) 720-2631
- NPI assigned
- Nov 24, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 2322 | MS | Primary |
Addresses
Primary practice location
718 Whippoorwill Dr
Brandon, MS 39047-7375
Mailing address
718 Whippoorwill Dr
Brandon, MS 39047-7375
Phone (601) 720-2631
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 |
|---|---|---|---|
| OT 2322 | MS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314921600000",
"number": "1609178680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 WHIPPOORWILL DR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390477375",
"telephone_number": "601-720-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 WHIPPOORWILL DR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390477375",
"telephone_number": "601-720-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "ANGELA",
"middle_name": "L",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-24",
"last_updated": "2011-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MS",
"license": "OT 2322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.