Individual provider Active NPI

Delana Cole Clemons, NP-C

  • Family Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1093296964
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131422 Issued in AL
Practice address
1201 7TH St SE
Decatur, AL 35601-3337
Phone
(256) 973-2606
NPI assigned
Aug 28, 2018
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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 1-131422 AL Primary

Addresses

Primary practice location

1201 7TH St SE
Decatur, AL 35601-3337

Mailing address

309 McNutt Dr NW
Hanceville, AL 35077-5480
Phone (256) 735-3914

Other practice location 1

1958 Al Highway 157
Cullman, AL 35058-0609
Phone (256) 737-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20181115001414 AL Practitioner - Nurse Practitioner 9931453610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Medical Alabama LLCGroup PAC ID 3072682103, 24 clinicians

Practice addresses (Care Compare)

1912 Al Hwy 157
Cullman, AL 35058-0609
Phone (240) 686-2300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Island Medical Alabama LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1093296964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MCNUTT DR NW",
            "city": "HANCEVILLE",
            "state": "AL",
            "postal_code": "350775480",
            "telephone_number": "256-735-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 7TH ST SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013337",
            "telephone_number": "256-973-2606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1958 Al Highway 157",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350580609",
            "country_code": "US",
            "telephone_number": "256-737-2090",
            "fax_number": "256-737-2091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "DELANA",
        "middle_name": "COLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.