Individual provider Active NPI

Clay Woodrow Reeves Jr., NP-C

  • Nurse Practitioner
  • Muskegon, MI
National Provider Identifier
1992015895
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704247153 Issued in MI
Practice address
2201 S Getty St
Muskegon, MI 49444-1207
Phone
(231) 739-9315
Fax
(231) 737-1808
NPI assigned
Oct 14, 2010
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20110329000118 MI Practitioner - Nurse Practitioner 2466635404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Urology PLC Past Accepting new patients
Emergency Health Partners Muskegon Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clayreeves@mfc.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/6463/brand/1/csg/1/fhir/r4
  • Direct secure messaging: creeves2079428@direct.trinity-health.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704247153 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

2201 S Getty St
Muskegon, MI 49444-1207

Mailing address

2201 S Getty St
Muskegon, MI 49444-1207
Phone (231) 739-9315

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4704247153OtherMILICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 2, 2015.

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1992015895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 S GETTY ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441207",
            "telephone_number": "231-739-9315",
            "fax_number": "231-737-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S GETTY ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441207",
            "telephone_number": "231-739-9315",
            "fax_number": "231-737-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "CLAY",
        "middle_name": "WOODROW",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704247153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704247153",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.