Jacqueline Clemons, LOTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5927 Issued in NC

Practice address

625 Ashland St
Archdale, NC 27263-2943

Phone

(336) 434-2902

Fax

(336) 434-4477

NPI assigned

Jan 17, 2012

Last updated

Jan 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1356201180

  Occupational Therapist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  dba Powerback Rehabilitation

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1003187451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5543 FRANCES CT",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271051772",
            "telephone_number": "336-624-3454",
            "fax_number": "336-744-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ASHLAND ST",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632943",
            "telephone_number": "336-434-2902",
            "fax_number": "336-434-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "JACQUELINE",
        "name_prefix": "Ms.",
        "credential": "LOTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolina Drug of Randolph County LLC (Carolina Drug)
• Nancy Barham Carter, BS
• Chad J. Miller DDS PA
• Claudia Melton, Inc
• Chelsie Claus
• Russell Floyd Cole, LCAS
• Diana Bernice Muth Cooper, PMHNP
• Cornerstone Health Care PA (Cornerstone Family Medicine at Archdale)
• Creative Home Health Care LLC
• Annemarie D'Andrea

• Occupational Therapist in Archdale, NC
• Providers in Archdale, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.