Lannette A Clemons, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50003274RX Issued in OH

Practice address

24 Morris Rd Ste 2
Shelby, OH 44875-1170

Phone

(419) 347-4177

Fax

(419) 347-9079

NPI assigned

May 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohiohealth Shelby Hospital Hospital, Shelby, OH, CCN 361324
• Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118
• Galion Community Hospital Hospital, Galion, OH, CCN 361325

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ohiohealth Corporation

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment Care Compare group
• Mercy Health Physicians North Specialty Care LLC

  • Surgery Physician
  • Toledo, OH
  • NPI 1306468418

  Single Specialty

  Medicare reassignment NPD
• Mercy Health Physicians-North LLC

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1609000769

  Single Specialty

  Medicare reassignment NPD
• Mercy Health Physicians - North, LLC

  • Customized Equipment (DME)
  • Perrysburg, OH
  • NPI 1992358766
  NPD
• Ohiohealth Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Columbus, OH
  • NPI 1265627301

  Single Specialty

  NPD
• Ohiohealth Corporation

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Galion Community Hospital

  • Critical Access Hospital
  • Galion, OH
  • NPI 1215907522
  Care Compare affiliation
• Medcentral Health System

  • Critical Access Hospital
  • Mansfield, OH
  • NPI 1487706016
  Care Compare affiliation
• Medcentral Health System

  • General Acute Care Hospital
  • Mansfield, OH
  • NPI 1790837235
  Care Compare affiliation
• Medcentral Health System

  • Clinical Medical Laboratory
  • Mansfield, OH
  • NPI 1962888016

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1043502172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "telephone_number": "419-347-4177",
            "fax_number": "419-347-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MORRIS RD STE 2",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448751170",
            "telephone_number": "419-347-4177",
            "fax_number": "419-347-9079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 S Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Willard",
            "state": "OH",
            "postal_code": "448901408",
            "country_code": "US",
            "telephone_number": "419-964-5380",
            "fax_number": "419-933-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "LANNETTE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50003274RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lclemons1011000@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "24 Morris Rd Ste 2",
            "city": "Shelby",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448751170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Mariann Carroll-Fackler, DC
• Samantha Carter, LSW
• Dakota Castle
• Ajay Chawla, MD
• City of Shelby
• Larry Alexander Clemons, CDCA
• Amy Beth Close, LSW, LCDC III
• Keshawn Cobb
• Tremarous Cobb
• Alexander Cole

• Physician Assistant in Shelby, OH
• Providers in Shelby, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.