Individual provider Active NPI

Paul R Clements, PHD, ARNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Belleair Beach, FL
National Provider Identifier
1053402974
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9231546 Issued in FL
Practice address
2605 Gulf Blvd
Belleair Beach, FL 33786-3500
Phone
(727) 641-5507
Fax
(866) 533-1384
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9231546 FL Primary

Addresses

Primary practice location

2605 Gulf Blvd
Belleair Beach, FL 33786-3500

Mailing address

2605 Gulf Blvd
Belleair Beach, FL 33786-3500
Phone (727) 641-5507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081104000455 FL Practitioner - Nurse Practitioner 2961474515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9231546FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
John P McDonough III Psychiatric/Mental Health CurrentSince Oct 1, 2004 Accepting new patients
GPS II PastSince Oct 1, 2004 Accepting new patients
George a Jacinto, PHD, LCSW, PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1053402974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 GULF BLVD",
            "city": "BELLEAIR BEACH",
            "state": "FL",
            "postal_code": "337863500",
            "telephone_number": "727-641-5507",
            "fax_number": "866-533-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 GULF BLVD",
            "city": "BELLEAIR BEACH",
            "state": "FL",
            "postal_code": "337863500",
            "telephone_number": "727-641-5507",
            "fax_number": "866-533-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD, ARNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9231546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleair Beach, FL

Sources for this page

Verify at the official NPI Registry.