NPIMap

Individual provider Active NPI

Bambi A Clay, PA-C

  • Physician Assistant
  • Hugo, OK
National Provider Identifier
1922077049
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1343 Issued in OK
Practice address
3004 E Jackson St
Hugo, OK 74743
Phone
(580) 326-9555
Fax
(580) 286-6699
NPI assigned
Mar 14, 2006
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18583 TX
Physician Assistant 363A00000X 1343 OK Primary

Addresses

Primary practice location

3004 E Jackson St
Hugo, OK 74743

Mailing address

3004 E Jackson St
Hugo, OK 74743-0219
Phone (580) 326-9555

Other practice location 1

1020 N Lawson Boulevard
Clayton, OK 74536-0219
Phone (918) 569-4143

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bambi.clay.3@4696.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040430000901 OK Practitioner - Physician Assistant 8729075601 Reassigns benefits to 2 organizations
I20050618000071 TX Practitioner - Physician Assistant 8729075601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6026 Battiest Pickens Rd
Broken Bow, OK 74728-5033
Phone 5802866688149

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1343OKMDPhysical Therapy Assistant
PA18583TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coal County General Hospital CurrentSince May 12, 2015 Accepting new patients
Coal County General Hospital CurrentSince May 12, 2015 Accepting new patients
Kiamichi Family Medical Center, Inc CurrentSince Oct 1, 2017 Accepting new patients
Holdenville Hospital Authority CurrentSince Jul 1, 2014 Accepting new patients
Kiamichi Family Medical Center, Inc CurrentSince May 18, 2025 Accepting new patients
Essent PRMC LP Past Accepting new patients
Choctaw Nation Health Services PastSince Jan 1, 1990 Accepting new patients
Choctaw Nation of Oklahoma PastSince Jan 1, 1990 Accepting new patients
Atoka County Healthcare Authority Past Accepting new patients
Good Honest Medicine Past Accepting new patients

Locations

1592 S Virginia Ave
Atoka, OK 74525
Phone (580) 889-3355

6 N Covington St
Coalgate, OK 74538
Phone (580) 927-2327

100 McDougal Dr
Holdenville, OK 74848
Phone (405) 379-4200

204 E Jackson St
Hugo, OK 74743
Phone (580) 326-9555

3004 E Jackson St
Hugo, OK 74743
Phone (580) 326-9555

2809 NE Lincoln Rd
Idabel, OK 74745
Phone (580) 286-6688

Interoperability endpoints

  • Direct secure messaging: bambi.clay.3@4696.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GDGBBA

Organizations & group practices 13

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.

View all 13

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1922077049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747430219",
            "telephone_number": "580-326-9555",
            "fax_number": "580-286-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "74743",
            "telephone_number": "580-326-9555",
            "fax_number": "580-286-6699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 N Lawson Boulevard",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "OK",
            "postal_code": "745360219",
            "country_code": "US",
            "telephone_number": "918-569-4143",
            "fax_number": "918-569-7552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAY",
        "first_name": "BAMBI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18583",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bambi.clay.3@4696.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1592 S Virginia Ave",
            "city": "Atoka",
            "state": "OK",
            "country_code": "US",
            "postal_code": "745253246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hugo, OK

Sources for this page

Verify at the official NPI Registry.