Individual provider Active NPI

Kayla Clemons, CRNP

  • Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1003206301
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-136281 Issued in AL
Practice address
6144 Airport Blvd
Mobile, AL 36608-3143
Phone
(251) 476-5050
Fax
(251) 450-2770
NPI assigned
Jan 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-136281 AL Primary

Addresses

Primary practice location

6144 Airport Blvd
Mobile, AL 36608-3143

Mailing address

PO Box 86144
Mobile, AL 36689-6144
Phone (251) 476-5050

Other identifiers 4

IdentifierTypeStateIssuer
Z98006OtherVIVA
176035MedicaidAL
P01499103OtherRR MEDICARE
511-60221OtherBCBS OF AL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150422002128 AL Practitioner - Nurse Practitioner 5991023913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Orthopaedic Group PCGroup PAC ID 2264331826, 67 clinicians

Practice addresses (Care Compare)

6144 Airport Blvd
Mobile, AL 36608-3143
Phone (251) 476-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
86.51
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-136281ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Group, PC CurrentSince Jan 2, 2015 Accepting new patients
The Orthopaedic Group, P.C. CurrentSince Jan 2, 2015 Accepting new patients

Locations

6144 Airport Blvd
Mobile, AL 36608
Phone (251) 342-0004

3610 Springhill Memorial Dr N
Mobile, AL 36608
Phone (251) 344-9630

880 Industrial Pkwy
Saraland, AL 36571

106 Saraland Loop
Ste 1061
Saraland, AL 36571

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1003206301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86144",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366896144",
            "telephone_number": "251-476-5050",
            "fax_number": "251-450-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083143",
            "telephone_number": "251-476-5050",
            "fax_number": "251-450-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "KAYLA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-136281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "Z98006",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176035",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01499103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "511-60221",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.