John Clemmons, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

52911 Issued in MS

Practice address

239 Methodist Blvd
Hattiesburg, MS 39402-1297

Phone

(601) 296-2125

Fax

(601) 268-8645

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wesley Physician Services LLCGroup PAC ID 2466559851, 42 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as apm

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• Direct secure messaging: john.clemmons.1@1930.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

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.

• Wesley Physician Services LLC

  • Family Medicine Physician
  • Hattiesburg, MS
  • NPI 1538200209

  Psychologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1104916766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 METHODIST BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021297",
            "telephone_number": "601-296-2125",
            "fax_number": "601-268-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 METHODIST BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021297",
            "telephone_number": "601-296-2125",
            "fax_number": "601-268-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "JOHN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "52911",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MS",
            "license": "52911",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MS",
            "license": "52911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03051508",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.clemmons.1@1930.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "239 Methodist Blvd",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394021297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ilyssa Claxton, CCSS
• Taylor Autrey Clayton, M.S., CF-SLP
• Kevin C Clearman, CNFP
• Selena Clearman, FNP-BC
• Kevin Bryan Clement, M.D.
• Clayton W Clifton Jr., RPH
• Ethan Clopton
• Coastal Pharmacy Services LLC
• Jessica Elisabeth Coates
• Corvell Coburn, LCSW, RN

• Psychologist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.