Individual provider Active NPI

Scott Jeffrey Clemons, NP-C

  • Family Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1053823047
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60799444 Issued in WA
Practice address
9537 Gravelly Lake Dr SW
Lakewood, WA 98499-1513
Phone
(253) 984-2000
Fax
(253) 984-2049
NPI assigned
Oct 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60799444 WA Primary

Addresses

Primary practice location

9537 Gravelly Lake Dr SW
Lakewood, WA 98499-1513

Mailing address

9537 Gravelly Lake Dr SW
Lakewood, WA 98499-1513
Phone (253) 984-2000

Other identifiers 1

IdentifierTypeStateIssuer
2090261MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sclemons593912@fhsce.catholichealth.net Direct
Direct Messaging Address sclemons593912@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171117002521 WA Practitioner - Nurse Practitioner 9739445107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

9230 Sky Island Dr E
FL 1
Bonney Lake, WA 98391-7385
Phone (253) 750-6022

Hospital & facility affiliations

  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 4, 2020 Accepting new patients
Franciscan Medical Group CurrentSince May 4, 2020 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group PastSince May 4, 2020 Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

9230 Sky Island Dr E
Fl 1
Bonney Lake, WA 98391
Phone (253) 750-6000

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

16045 1st Ave S
Fl 1
Burien, WA 98148
Phone (206) 965-4100

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

4700 Point Fosdick Dr
Ste 102
Gig Harbor, WA 98335
Phone (206) 858-3200

450 S Kitsap Blvd
Ste 100
Port Orchard, WA 98366
Phone (360) 744-6275

15214 Canyon Rd E
Ste 120
Puyallup, WA 98375
Phone (253) 539-4200

1344 Wintergreen Ln NE
Unit 100
Seattle, WA 98110
Phone (206) 201-0488

4550 Fauntleroy Way SW
Ste 200
Seattle, WA 98126
Phone (206) 933-1041

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

9537 Gravelly Lake Dr SW
Tacoma, WA 98499
Phone (253) 984-2000

3556 Market Pl W
Ste 109
University Place, WA 98466
Phone (253) 215-1095

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: sclemons593912@fhsce.catholichealth.net

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1053823047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9537 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991513",
            "telephone_number": "253-984-2000",
            "fax_number": "253-984-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9537 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991513",
            "telephone_number": "253-984-2000",
            "fax_number": "253-984-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "SCOTT",
        "middle_name": "JEFFREY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60799444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2090261",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclemons593912@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9230 Sky Island Dr E",
            "city": "Bonney Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983917385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sclemons593912@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9537 Gravelly Lake Dr SW",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984991513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.