Individual provider Active NPI

Nicole Anne Clem, ARNP

  • Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1023405222
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95020665 Issued in CA
Practice address
1825 4TH St
San Francisco, CA 94143-2350
Phone
(415) 353-7175
NPI assigned
Apr 25, 2015
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95020665 CA Primary
Nurse Practitioner 363L00000X 209020656 IL

Addresses

Primary practice location

1825 4TH St
San Francisco, CA 94143-2350

Mailing address

150 Harvester Dr Ste 300
Burr Ridge, IL 60527-5965

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Other identifiers 3

IdentifierTypeStateIssuer
016992700MedicaidFL
13548879OtherFLCAQH
Q3K4TOtherFLBCBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, IL, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150611000889 AL Practitioner - Nurse Practitioner 1456672773 Reassigns benefits to 1 organization
I20200810000068 IL Practitioner - Nurse Practitioner 1456672773 Reassigns benefits to 2 organizations
I20230317002392 CA Practitioner - Nurse Practitioner 1456672773 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jun 26, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Dec 14, 2022 Accepting new patients
The University of Chicago Medical Center CurrentSince Jun 26, 2020 Accepting new patients
University of California San Francisco CurrentSince Dec 14, 2022 Accepting new patients
Oak Mountain Group Services, LLC Current Accepting new patients
UCSF Medical Group Business Services Nurse Practitioner CurrentSince Dec 14, 2022 Accepting new patients
UCSF Dept of Surgery CurrentSince Dec 14, 2023 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Mar 1, 2018 Accepting new patients
University of California San Francisco CurrentSince Dec 14, 2022 Accepting new patients
Regents of the University of California CurrentSince Dec 14, 2022 Accepting new patients
University of California San Francisco Current Accepting new patients

Locations

3070 Healthy Way
Vestavia, AL 35243
Phone (205) 977-7216

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

1825 4th St
San Francisco, CA 94143
Phone (415) 353-3000

2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: nclem191124@uchospital.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1023405222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 4TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432350",
            "telephone_number": "415-353-7175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S MARYLAND AVE",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "888-824-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEM",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95020665",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016992700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13548879",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Q3K4T",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.