Individual provider Active NPI

Mia Jones Clermont, APRN, RN

  • Pediatric Nurse Practitioner
  • Tullahoma, TN
National Provider Identifier
1033908546
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
281436 Issued in TN
Practice address
1330 Cedar LN Ste 900
Tullahoma, TN 37388-2286
Phone
(931) 455-2674
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 281436 TN Primary

Addresses

Primary practice location

1330 Cedar LN Ste 900
Tullahoma, TN 37388-2286

Mailing address

1330 Cedar LN Ste 900
Tullahoma, TN 37388-2286
Phone (931) 455-2674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
281436TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tullahoma Pediatrics PLLC PastSince Oct 21, 2025 Accepting new patients

Interoperability endpoints

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1033908546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 CEDAR LN STE 900",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882286",
            "telephone_number": "931-455-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CEDAR LN STE 900",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882286",
            "telephone_number": "931-455-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERMONT",
        "first_name": "MIA",
        "middle_name": "JONES",
        "credential": "APRN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "281436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.