Individual provider Active NPI

Beverly Lynn Clayton, NURSE PRACTITIONER

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1972831378
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11218 Issued in OH
Practice address
2638 Hemlock St
Cincinnati, OH 45206-1608
Phone
(513) 256-7170
Fax
(513) 227-0114
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 207605 OH
Nurse Practitioner 363L00000X 11218 OH Primary

Addresses

Primary practice location

2638 Hemlock St
Cincinnati, OH 45206-1608

Mailing address

619 Oak St
Cincinnati, OH 45206-1608
Phone (513) 569-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328002600 OH Practitioner - Nurse Practitioner 7810272168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11218OHMDNurse Practitioner
207605OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Surestep Foot & Ankle Medical Center, LLC Past Accepting new patients

Organizations & group practices 1

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": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1972831378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 OAK ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061608",
            "telephone_number": "513-569-6555",
            "fax_number": "513-624-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 HEMLOCK ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061608",
            "telephone_number": "513-256-7170",
            "fax_number": "513-227-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "BEVERLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "207605",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "11218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.