Individual provider Active NPI

Joshua Glen Clements, RSA

  • Surgical Technologist
  • Houston, TX
National Provider Identifier
1073808721
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
238.000287 Issued in IL
Practice address
10039 Bissonnet St Ste 250
Houston, TX 77036-7852
Phone
(815) 545-7750
NPI assigned
Jun 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 238.000287 IL
Surgical Technologist 246ZS0410X 238.000287 IL Primary
Surgical Physician Assistant 363AS0400X 238.000287 IL

Addresses

Primary practice location

10039 Bissonnet St Ste 250
Houston, TX 77036-7852

Mailing address

30907 Correct Craft LN
Wilmington, IL 60481-2147
Phone (815) 545-7750

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

State licenses

LicenseStateTypeSpecialty
238.000287ILMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1073808721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30907 CORRECT CRAFT LN",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604812147",
            "telephone_number": "815-545-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 BISSONNET ST STE 250",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770367852",
            "telephone_number": "815-545-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "JOSHUA",
        "middle_name": "GLEN",
        "credential": "RSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238.000287",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "IL",
            "license": "238.000287",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238.000287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; 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.