Individual provider Active NPI

Thomas R Clay, D.O.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1902874191
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1929 Issued in NV
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

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1902874191MedicaidNV

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151230002073 NV Practitioner - Family Practice 0941219091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO1929NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.