Individual provider Active NPI

Beth Clements, RN

  • Ambulatory Care Registered Nurse
  • La Crosse, WI
National Provider Identifier
1063987576
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
220479-30 Issued in WI
Practice address
4000 State Road 16
La Crosse, WI 54601-1809
Phone
(608) 784-3886
NPI assigned
Oct 11, 2018
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 220479-30 WI
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 220479-30 WI
Ambulatory Care Registered Nurse 163WP2201X 220479-30 WI Primary

Addresses

Primary practice location

4000 State Road 16
La Crosse, WI 54601-1809

Mailing address

4000 State Road 16
La Crosse, WI 54601-1809
Phone (608) 498-2125

Other identifiers 1

IdentifierTypeStateIssuer
1003150004MedicaidWI

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220479-30WIMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1063987576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 STATE ROAD 16",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546011809",
            "telephone_number": "608-498-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 STATE ROAD 16",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546011809",
            "telephone_number": "608-784-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "BETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "220479-30",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "220479-30",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "WI",
            "license": "220479-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003150004",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.