Bambi A Clay, PA-C
Individual provider Active NPI Physician Assistant · Hugo, OK
NPI 1922077049 · NPPES record last updated Jan 10, 2025
Key facts
- NPI
- 1922077049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1343 (OK)
- Practice address
- 3004 E Jackson St
Hugo, OK 74743 - Phone
- (580) 326-9555
- Fax
- (580) 286-6699
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kiamichi Family Medical Center Inc.
Practice addresses (Care Compare)
6026 Battiest Pickens Rd
Broken Bow, OK 74728-5033
Phone 5802866688149
Hospital & facility affiliations
- Mays Housecall Home Health of Antlers, LLC
- Atoka County Medical Center
- Paris Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040430000901 | OK | Practitioner - Physician Assistant | 8729075601 | Reassigns benefits to 2 organizations |
| I20050618000071 | TX | Practitioner - Physician Assistant | 8729075601 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1343 | OK | MD | Physical Therapy Assistant |
| PA18583 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coal County General Hospital | Current |
Accepting new patients | |
| Kiamichi Family Medical Center, Inc | Current |
Accepting new patients | |
| Coal County General Hospital | Current |
Accepting new patients | |
| Kiamichi Family Medical Center, Inc | Current |
Accepting new patients | |
| Kiamichi Family Medical Center Inc. | Current |
Accepting new patients | |
| Essent PRMC LP | Past | Accepting new patients | |
| Good Honest Medicine | Past | Accepting new patients | |
| Choctaw Nation Health Services | Past |
Accepting new patients | |
| Atoka County Healthcare Authority | Past | Accepting new patients | |
| Choctaw Nation of Oklahoma | 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
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
- https://fhir4.healow.com/fhir/r4/GDGBBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18583 | TX | |
| Physician Assistant | 363A00000X | 1343 | OK | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16001343 | Medicaid | OK |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bambi.clay.3@4696.direct.athenahealth.com |
Other providers in Hugo, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.