Clede Kemayu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1060445 Issued in TX

Practice address

1200 Excellence Dr
Lucas, TX 75098-1848

Phone

(469) 328-1102

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mind Vibe PC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1538933080

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1063155018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EXCELLENCE DR",
            "city": "LUCAS",
            "state": "TX",
            "postal_code": "750981848",
            "telephone_number": "469-328-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EXCELLENCE DR",
            "city": "LUCAS",
            "state": "TX",
            "postal_code": "750981848",
            "telephone_number": "469-328-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMAYU",
        "first_name": "CLEDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1060445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Glorioso, RPH
• Uzma Hajiyani
• Bernadine Harshman
• Alida Jones, RN
• Billy Bryson Kelley, LMT
• Sheeda Khavari, PHARMD
• Nicole Renee Kotaska
• Kyla M. Slaughter
• Lovejoy Counseling LLC
• Lovejoy Dentistry

• All providers in Lucas, TX
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.