Edward Jacob Clemons III, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1015 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6653

Phone

(404) 523-6571

NPI assigned

May 22, 2023

Last updated

May 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CJECDA

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.

• Hope First Investments

  dba Hope 1st Pharmacy

  • Pharmacy
  • Atlanta, GA
  • NPI 1861114977
  NPD
• The Good Samaritan Health Center, Inc.

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1629254008
  NPD

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1003508755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186653",
            "telephone_number": "404-523-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "EDWARD",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra D Clements, R.N.
• Stephen D Clements Jr., MD
• Andrew R Clementz, MD
• Elish Akeria Clemmons
• Avery Clemons, RBT
• Javonya Donell Clemons, M.S., CCC-SLP
• Kennedi Clemons
• Khatonya Clemons
• Peggy Clemons
• Summer Soleil Elizabeth Clemons

• Student in an Organized Health Care Education/Training Program in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.