Active NPI
Clay Emergency Group LLC
- Emergency Medicine Physician
- Liberty, MO
National Provider Identifier
1972941979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- CLAY EMERGENCY GROUP LLC
- Practice address
- 2525 Glenn Hendren Dr
Liberty, MO 64068-9625 - Phone
- (800) 893-9698
- NPI assigned
- Jun 12, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisha C Falk
- Title
- VP of Contracting
- Phone
- (800) 893-9698
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
2525 Glenn Hendren Dr
Liberty, MO 64068-9625
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (337) 354-1153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972941979 | Medicaid | MO |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370995200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1455580800000",
"number": "1972941979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "337-354-1153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 GLENN HENDREN DR",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640689625",
"telephone_number": "800-893-9698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLAY EMERGENCY GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-12",
"last_updated": "2016-02-16",
"status": "A",
"authorized_official_last_name": "FALK",
"authorized_official_first_name": "LISHA",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "VP OF CONTRACTING",
"authorized_official_telephone_number": "800-893-9698"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1972941979",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.