Individual provider Active NPI

Jessica Nicole Clements, FNP-BC

  • Nurse Practitioner
  • Roanoke Rapids, NC
National Provider Identifier
1114408861
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5010879 Issued in NC
Practice address
210 Smith Church Rd
Roanoke Rapids, NC 27870-4942
Phone
(252) 535-8144
NPI assigned
Aug 21, 2018
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5010879 NC Primary

Addresses

Primary practice location

210 Smith Church Rd
Roanoke Rapids, NC 27870-4942

Mailing address

210 Smith Church Rd
Roanoke Rapids, NC 27870-4942

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jivey296811@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200130000786 NC Practitioner - Nurse Practitioner 3870929490 Reassigns benefits to 2 organizations
I20220421000908 VA Practitioner - Nurse Practitioner 3870929490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

210 Smith Church Rd
BLDG 1
Roanoke Rapids, NC 27870-4942
Phone (252) 535-8463

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010879NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Regional Medical Center Inc CurrentSince Jan 1, 2020 Accepting new patients
Hospitality Health Quick Care PLLC CurrentSince Mar 1, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 1, 2021 Accepting new patients
Halifax Regional Medical Center Inc Current Accepting new patients
Moye Medical Endoscopy Center LLC PastSince Jun 1, 2021 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1385 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 537-9176

210 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 535-8011

210 Smith Church Rd
Bldg 1
Roanoke Rapids, NC 27870
Phone (252) 535-8463

210 Smith Church Rd
Ste A
Roanoke Rapids, NC 27870
Phone (252) 535-8463

210 Smith Church Rd
Ste B
Roanoke Rapids, NC 27870
Phone (252) 535-8870

301 Market Dr
Ste G
Emporia, VA 23847
Phone (434) 230-9080

Interoperability endpoints

  • Direct secure messaging: jivey296811@direct.vidanthealth.com

Organizations & group practices 5

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": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1114408861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704942",
            "telephone_number": "252-535-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5010879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jivey296811@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.