Organization Active NPI

Rosa E. Clemente, M.D., P.C.

  • Nephrology Physician
  • Griffin, GA
National Provider Identifier
1003080607
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
024918 Issued in GA
Legal business name
ROSA E. CLEMENTE, M.D., P.C.
Practice address
415 S 8TH St
Griffin, GA 30224-4208
Phone
(770) 228-3929
Fax
(770) 228-9837
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Dr. Rosa Estipona Clemente, M.D.
Title
Nephrologist
Phone
(770) 228-5187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 024918 GA Primary

Addresses

Primary practice location

415 S 8TH St
Griffin, GA 30224-4208

Mailing address

415 S 8TH St
Griffin, GA 30224-4208
Phone (770) 228-3929

Other identifiers 1

IdentifierTypeStateIssuer
00265515AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1003080607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244208",
            "telephone_number": "770-228-3929",
            "fax_number": "770-228-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244208",
            "telephone_number": "770-228-3929",
            "fax_number": "770-228-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSA E. CLEMENTE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "CLEMENTE",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "ESTIPONA",
        "authorized_official_title_or_position": "NEPHROLOGIST",
        "authorized_official_telephone_number": "770-228-5187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "024918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00265515A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.