Individual provider Active NPI

Clayton W Nuelle, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Columbia, MO
National Provider Identifier
1811125859
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
2013044289 Issued in MO
Practice address
1100 Virginia Ave
Columbia, MO 65212-0001
Phone
(573) 882-2663
Fax
(573) 882-1760
NPI assigned
Jun 29, 2009
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X R2933 TX
Orthopaedic Surgery Physician 207X00000X 2013044289 MO
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 2013044289 MO Primary

Addresses

Primary practice location

1100 Virginia Ave
Columbia, MO 65212-0001

Mailing address

PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300

Other practice location 1

19138 US Highway 281 N Ste 100
San Antonio, TX 78258-4988
Phone (210) 804-5995

Other practice location 2

400 Concord Plaza Dr Ste 300
San Antonio, TX 78216-6991
Phone (210) 804-5995

Other practice location 3

601 Creekside Xing Ste 106
New Braunfels, TX 78130-4093
Phone (210) 804-5995

Other identifiers 1

IdentifierTypeStateIssuer
200015413MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20140815000327 MO Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 3072757459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 Virginia Ave
Columbia, MO 65212-0001
Phone (573) 882-2667

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement13
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013044289MOMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Curators of the University of Missouri CurrentSince Aug 1, 2014 Accepting new patients
Curators of the University of Missouri CurrentSince Aug 1, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

1100 Virginia Ave
Columbia, MO 65212
Phone (573) 882-2663

3 Hospital Dr
Columbia, MO 65201
Phone (573) 882-8913

1432 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5560

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Interoperability endpoints

  • Direct secure messaging: clayton.nuelle.1@94.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1811125859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 VIRGINIA AVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-882-2663",
            "fax_number": "573-882-1760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19138 US Highway 281 N Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782584988",
            "country_code": "US",
            "telephone_number": "210-804-5995",
            "fax_number": "210-804-5996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Concord Plaza Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782166991",
            "country_code": "US",
            "telephone_number": "210-804-5995",
            "fax_number": "210-804-5996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Creekside Xing Ste 106",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781304093",
            "country_code": "US",
            "telephone_number": "210-804-5995",
            "fax_number": "210-804-5996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUELLE",
        "first_name": "CLAYTON",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "R2933",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2013044289",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2013044289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015413",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "3 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652015276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.