Robert Willard Clemons Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23534 Issued in IA

Practice address

220 Essie Davison Dr
Clarinda, IA 51632-2915

Phone

(712) 542-2176

Fax

(712) 542-8397

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcrclemons@mcmh.cernerdirect.com

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.

• Clarinda Regional Health Center

  • Family Medicine Physician
  • Clarinda, IA
  • NPI 1629196241
  Medicare reassignment NPD
• Montgomery County Memorial Hospital

  • Internal Medicine Physician
  • Red Oak, IA
  • NPI 1265405310
  Medicare reassignment NPD
• Montgomery County Memorial Hospital

  • Critical Access Hospital
  • Red Oak, IA
  • NPI 1376539338
  Medicare reassignment NPD
• Montgomery County Memorial Hospital

  • Community/Retail Pharmacy
  • Red Oak, IA
  • NPI 1699887547
  NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1013963339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516320217",
            "telephone_number": "712-542-2176",
            "fax_number": "712-542-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ESSIE DAVISON DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322915",
            "telephone_number": "712-542-2176",
            "fax_number": "712-542-8397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Essie Davison Dr # Er",
            "address_purpose": "LOCATION",
            "city": "Clarinda",
            "state": "IA",
            "postal_code": "516322915",
            "country_code": "US",
            "telephone_number": "712-542-2176",
            "fax_number": "712-542-8324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1207 Madison St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IA",
            "postal_code": "508331036",
            "country_code": "US",
            "telephone_number": "712-523-1146",
            "fax_number": "712-542-6720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Villisca",
            "state": "IA",
            "postal_code": "508641160",
            "country_code": "US",
            "telephone_number": "712-826-3003",
            "fax_number": "712-826-3043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "ROBERT",
        "middle_name": "WILLARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "23534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417824",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarinda Youth Corporation
• Clarinda Youth Corporation
• Clarinda Youth Corporation
• Kala Clark, PMHNP
• Shelley Renee Clayton, LCSW
• Jessica Coburn
• Ann Marie Davison, R.N.
• Lauren Rae Davison, ARNP
• Jessica L Divine, LMSW
• Easter Enterprises, Inc.

• Family Medicine Physician in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.