Angela Coleen Moore Clay, D.O.
Individual provider Active NPI Family Medicine Physician · Fordland, MO
NPI 1992899645 · NPPES record last updated Mar 18, 2024
Key facts
- NPI
- 1992899645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2001026670 (MO)
- Practice address
- 1059 Barton Dr
Fordland, MO 65652-7350 - Phone
- (417) 767-2273
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fordland Clinic, Inc.
Macon County Samaritan Hospital
Cherry Health Center, LLC
Practice addresses (Care Compare)
1059 Barton Dr
Fordland, MO 65652-7350
Phone 41776722732022
1205 N Missouri St
Macon, MO 63552-2095
Phone (660) 385-8700
607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000
Hospital & facility affiliations
- Macon County Samaritan Memorial Hospital
- Cox Medical Centers
- Mercy Hospital Springfield
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080228000166 | MO | Practitioner - Family Practice |
7517041627 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO2001026670 | MO | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fordland Clinic, Inc. | Current |
Accepting new patients | |
| Macon County Samaritan Hospital | Current |
Accepting new patients | |
| Southeastern Emergency Physicians of Memphis LLC | Emergency Medicine | Current |
Accepting new patients |
| Camden Emergency Group LLC | Emergency Medicine | Current |
Accepting new patients |
| Teladoc Health Medical Group, P.a. | Family Medicine | Current |
Accepting new patients |
| Fordland Clinic, Inc. | Current |
Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000
1059 Barton Dr
Fordland, MO 65652
Phone (417) 767-2100
1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500
1300 E Bradford Pkwy
Springfield, MO 65804
Phone (417) 269-5400
1945 Lakepointe Dr
Ste 100
Lewisville, TX 75057
Phone (855) 224-7315
Interoperability endpoints
- aclay@11ef84f8.micromddirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MO2001026670 | MO | |
| Family Medicine Physician | 207Q00000X | 2001026670 | MO | Yes |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | MO2001026670 | MO |
Addresses
Primary practice location
1059 Barton Dr
Fordland, MO 65652-7350
Mailing address
100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6350
Other practice location 1
11863 State Highway 13
Kimberling City, MO 65686-8362
Phone (417) 739-1995
Other practice location 2
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 767-2273
Other practice location 3
100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209221001 | Medicaid | MO | |
| P00750135 | Other | MO | RAILROAD MEDICARE |
Other providers in Fordland, MO
- Loretta Baker-Montgomery
- Reed Brighton Bisso
- Brewer Counseling, LLC
- Peggy S Cargin
- Debby Sue Carl
- Kayla Cummings
- Tina Nichole Drozdowski
- Robert Daniel Dunavant
- Ronica Jean Duncan
- Fordland Clinic, Inc.
All providers in Fordland, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2024. 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.