Individual provider Active NPI

Nancy Katrina Clay, APRN

  • Nurse Practitioner
  • Sidney, KY
National Provider Identifier
1609807544
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45912 Issued in WV
Practice address
17379 East Big Creek Road
Sidney, KY 41564-8574
Phone
(606) 353-6926
NPI assigned
Jul 6, 2006
Last updated
Mar 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45912 WV Primary

Addresses

Primary practice location

17379 East Big Creek Road
Sidney, KY 41564-8574

Mailing address

818 Trace Creek Rd
Delbarton, WV 25670-9689
Phone (606) 625-2332

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000317 WV Practitioner - Nurse Practitioner 8224942354 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3804KYMDSocial Worker
45912WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Alliance, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Cherokee Emergency Services, Inc. Nurse Practitioner CurrentSince Jan 16, 2014 Accepting new patients
Appalachian Regional Healthcare, Inc. Nurse Practitioner Past Accepting new patients
Elm Emergency Group PLLC Nurse Practitioner Past Accepting new patients
Southeastern Emergency Services P C Nurse Practitioner Past Accepting new patients
Holistic Medical LLC Past Accepting new patients
Appalachian Regional Healthcare, Inc Nurse Practitioner Past Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients

Locations

124 Brookshire Ln
Beckley, WV 25801
Phone (304) 252-8551

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1609807544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 TRACE CREEK RD",
            "city": "DELBARTON",
            "state": "WV",
            "postal_code": "256709689",
            "telephone_number": "606-625-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17379 EAST BIG CREEK ROAD",
            "city": "SIDNEY",
            "state": "KY",
            "postal_code": "415648574",
            "telephone_number": "606-353-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "NANCY",
        "middle_name": "KATRINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "45912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, KY

Sources for this page

Verify at the official NPI Registry.