Clyde McClellan Stauffer, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E-15156 Issued in AR

Practice address

7001 Rogers Ave Ste 600
Fort Smith, AR 72903-4073

Phone

(479) 573-3101

Fax

(479) 573-3102

NPI assigned

May 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Lincoln Memorial University Medical Department, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Fort Smith CommunitiesGroup PAC ID 3870668510, 361 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
• Mercy Hospital Paris Hospital, Paris, AR, CCN 041300
• Mercy Hospital Waldron Hospital, Waldron, AR, CCN 041305

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cstauffer1307759@directc.mercy.net

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.

• Mercy Clinic Fort Smith Communities

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1902073620
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Fort Smith Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Smith, AR
  • NPI 1790258002
  NPD
• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  NPD (past)

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Mercy Hospital Paris

  • Critical Access Hospital
  • Paris, AR
  • NPI 1760453633
  Care Compare affiliation
• Mercy Hospital Waldron

  • Critical Access Hospital
  • Waldron, AR
  • NPI 1912978875
  Care Compare affiliation

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1669909255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 600",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034073",
            "telephone_number": "479-573-3101",
            "fax_number": "479-573-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ROGERS AVE STE 600",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729034073",
            "telephone_number": "479-573-3101",
            "fax_number": "479-573-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-205-7182",
            "fax_number": "517-205-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "CLYDE",
        "middle_name": "MCCLELLAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101022979",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E-15156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna S Stanley, MHPP
• Caleb Stanton, DO
• Andrew Bradley Starnes, MD, MPH
• Emily Ann Starr
• Richard Alan Staton, DDS
• Madison Nicole Stave
• Jerry Stearman, LPE
• Lisa Rene Stearman, MSCCCSLP
• Keith Elliott Stearns, P.D.
• Chelsi Steele

• Surgery Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.