Active NPI
Thomas R Clay, D.O.
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1902874191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DO1929
- Practice address
- 4880 Wynn Rd
Las Vegas, NV 89103-5406 - Phone
- (702) 871-5005
- Fax
- (702) 871-1349
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO1929 | NV | Primary |
Addresses
Primary practice location
4880 Wynn Rd
Las Vegas, NV 89103-5406
Mailing address
PO Box 98978
Las Vegas, NV 89193-8978
Phone (702) 216-3346
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902874191 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151230002073 | NV | Practitioner - Family Practice | 0941219091 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO1929 | NV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Partners Medical Group Coats LTD | Family Medicine | Current | Accepting new patients |
| Intermountain Medical Holdings Nevada Inc | Family Medicine | Past | Accepting new patients |
Locations
4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Las Vegas, NV
- NPI 1487631917
-
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451347200000",
"number": "1902874191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98978",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891938978",
"telephone_number": "702-216-3346",
"fax_number": "702-671-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4880 WYNN RD",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891035406",
"telephone_number": "702-871-5005",
"fax_number": "702-871-1349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "THOMAS",
"middle_name": "R",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2015-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "DO1929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1902874191",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.