Individual provider Active NPI

Denise E Clay, M.D.

  • Internal Medicine Physician
  • Wytheville, VA
National Provider Identifier
1952337925
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101251147 Issued in VA
Practice address
1785 W Lee Hwy
Wytheville, VA 24382-1437
Phone
(276) 228-6499
Fax
(276) 228-3311
NPI assigned
Jun 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME52039 FL
Internal Medicine Physician 207R00000X 0101251147 VA Primary

Addresses

Primary practice location

1785 W Lee Hwy
Wytheville, VA 24382-1437

Mailing address

1785 W Lee Hwy
Wytheville, VA 24382-1437
Phone (276) 228-6499

Other identifiers 1

IdentifierTypeStateIssuer
1952337925MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20120323000393 VA Practitioner - Family PracticePractitioner - Internal Medicine 1759321250 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101251147VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Family Care, Inc CurrentSince Dec 7, 2015 Accepting new patients
Inphynet South Broward LLC Emergency Medicine Past Accepting new patients

Locations

1785 W Lee Hwy
Wytheville, VA 24382
Phone (276) 228-6499

Interoperability endpoints

  • Direct secure messaging: denise.clay@bcmc.eclinicaldirectplus.com

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1952337925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821437",
            "telephone_number": "276-228-6499",
            "fax_number": "276-228-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W LEE HWY",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821437",
            "telephone_number": "276-228-6499",
            "fax_number": "276-228-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "DENISE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME52039",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101251147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952337925",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.