Individual provider Active NPI

Tammy D Clayton, PA-C

  • Physician Assistant
  • Madisonville, KY
National Provider Identifier
1629039201
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA529 Issued in KY
Practice address
444 S Main St
Madisonville, KY 42431-2871
Phone
(270) 821-4444
Fax
(270) 821-9188
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA529 KY Primary

Addresses

Primary practice location

444 S Main St
Madisonville, KY 42431-2871

Mailing address

444 S Main St
Madisonville, KY 42431-2871
Phone (270) 821-4444

Other practice location 1

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

Other identifiers 2

IdentifierTypeStateIssuer
9500114500MedicaidKY
000000475416OtherKYBCBS #

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tclayton4757@direct.owensborohealth.org
Direct Messaging Address tclayton4757@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040419000408 KY Practitioner - Physician Assistant 3173518206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc. CurrentSince May 1, 2006 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince May 1, 2006 Accepting new patients
Owensboro Health Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

510 Ruby Dr
Madisonville, KY 42431
Phone (270) 399-7757

444 S Main St
Madisonville, KY 42431
Phone (270) 821-4444

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health Medical Group Inc 455 clinicians

Practice addresses (Care Compare)

2211 Mayfair Dr
Owensboro, KY 42301-4569

510 Ruby Dr
Madisonville, KY 42431-2168
Phone (270) 399-7900

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1629039201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 S MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312871",
            "telephone_number": "270-821-4444",
            "fax_number": "270-821-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312871",
            "telephone_number": "270-821-4444",
            "fax_number": "270-821-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 Ruby Dr",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "424312168",
            "country_code": "US",
            "telephone_number": "270-399-7900",
            "fax_number": "270-399-7910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "TAMMY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9500114500",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "000000475416",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tclayton4757@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "444 S Main St",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tclayton4757@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "510 Ruby Dr",
            "city": "Madisonville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "424312168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.