Individual provider Active NPI

Tricia Ann Clayton, MSN,FNP-BC,NP-C

  • Family Nurse Practitioner
  • Alton, IL
National Provider Identifier
1679963920
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012478 Issued in IL
Practice address
3 Professional Dr Ste B
Alton, IL 62002-5067
Phone
(618) 465-7177
Fax
(618) 465-7176
NPI assigned
Jan 26, 2015
Last updated
Sep 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012478 IL Primary

Addresses

Primary practice location

3 Professional Dr Ste B
Alton, IL 62002-5067

Mailing address

131 Saundersville Road
Suite 160
Hendersonville, TN 37075
Phone (314) 317-0184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150317001602 IL Practitioner - Nurse Practitioner 5890010920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Interventional Pain Consultants LLCGroup PAC ID 7618225020, 6 clinicians

Practice addresses (Care Compare)

3 Professional Dr
Suite B
Alton, IL 62002-5011
Phone (618) 465-7177

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.58 of 100Reported as group
Quality
91.56
Promoting interoperability
96
Improvement activities
40
Cost
74.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209012478ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Consultants LLC CurrentSince Aug 1, 2018 Accepting new patients
Interventional Pain Consultants LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

3 Professional Dr
Ste B
Alton, IL 62002
Phone (618) 219-0855

4972 Benchmark Centre Dr
Swansea, IL 62226
Phone (618) 622-0303

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1679963920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SAUNDERSVILLE ROAD",
            "address_2": "SUITE 160",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "314-317-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PROFESSIONAL DR STE B",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025067",
            "telephone_number": "618-465-7177",
            "fax_number": "618-465-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "TRICIA",
        "middle_name": "ANN",
        "credential": "MSN,FNP-BC,NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.