Individual provider Active NPI

Nailah Aisha Gallego Clemmons, MD

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1023578689
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2026007147 Issued in MO
Practice address
1 Childrens PL
Div Ped Academics, Ste 2D
Saint Louis, MO 63110-1002
Phone
(314) 454-6300
Fax
(833) 969-0131
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2026007147 MO Primary

Addresses

Primary practice location

1 Childrens PL
Div Ped Academics, Ste 2D
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-6300

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20240405000942 LA Practitioner - Pediatric Medicine 2365823911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0093534MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Feb 20, 2024 Accepting new patients
University Healthcare System, L.C. Past Accepting new patients
Children's Hospital Pediatrics Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

4845 Veterans Memorial Blvd
#48
Metairie, LA 70006
Phone (504) 883-3703

4845 Veterans Memorial Blvd
Metairie, LA 70006

1100 Poydras St
Ste 2500
New Orleans, LA 70163
Phone (504) 527-9953

Organizations & group practices 4

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1023578689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-6300",
            "fax_number": "833-969-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED ACADEMICS, STE 2D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6300",
            "fax_number": "833-969-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGO CLEMMONS",
        "first_name": "NAILAH",
        "middle_name": "AISHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-08-11",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2026007147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Academics, Ste 2D",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.