Active NPI
Melissa K Clements, M.D.
- Specialist
- Oklahoma City, OK
National Provider Identifier
1114079597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 14621
- Practice address
- 6301 Waterford Blvd
Suite 100
Oklahoma City, OK 73118-1162 - Phone
- (405) 843-7401
- Fax
- (405) 843-7607
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 14621 | OK | Primary |
Addresses
Primary practice location
6301 Waterford Blvd
Suite 100
Oklahoma City, OK 73118-1162
Mailing address
6301 Waterford Blvd
Suite 100
Oklahoma City, OK 73118-1162
Phone (405) 843-7401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 1, 2015 through Sep 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14621 | OK | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114079597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 WATERFORD BLVD",
"address_2": "SUITE 100",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181162",
"telephone_number": "405-843-7401",
"fax_number": "405-843-7607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 WATERFORD BLVD",
"address_2": "SUITE 100",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731181162",
"telephone_number": "405-843-7401",
"fax_number": "405-843-7607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENTS",
"first_name": "MELISSA",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OK",
"license": "14621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.