Derek Alan Clemmer, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

3565-10 Issued in MS

Practice address

15921 Boundary Dr
Ashland, MS 38603-7740

Phone

(662) 224-8951

NPI assigned

Aug 5, 2010

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

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• MS PPO C-SNP
• LA PPO C-SNP
• MS PPO D-SNP

Interoperability endpoints

• Direct secure messaging: derekclemmer@nmhs.medalliesdirect.net
• Direct secure messaging: derek_clemmer_md_oral_surgeon@yourcarecommunity.org

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.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment NPD (past)
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Critical Access Hospital
  • Aberdeen, MS
  • NPI 1285164046
  Medicare reassignment
• North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1376969683
  NPD
• Boa Vida Hospital of Aberdeen, Ms, LLC

  • Rural Health Clinic/Center
  • Aberdeen, MS
  • NPI 1245757301
  NPD (past)

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280966400000",
    "number": "1023322765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92",
            "city": "ASHLAND",
            "state": "MS",
            "postal_code": "386030092",
            "telephone_number": "662-224-8951",
            "fax_number": "662-224-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15921 BOUNDARY DR",
            "city": "ASHLAND",
            "state": "MS",
            "postal_code": "386037740",
            "telephone_number": "662-224-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMER",
        "first_name": "DEREK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3565-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mattie J Burns
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• Brenda Kay Craine, BSW
• Family Medical Equipment
• Hearts at Home ,LLC
• Irshad Hussain, MD
• Brandon Wesley Hutchison, FNP

• Dentist in Ashland, MS
• Providers in Ashland, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; 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.
• 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.