Individual provider Active NPI

David H Clements, PA-C

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1114917168
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-500 Issued in ID
Practice address
4424 E Flamingo Ave
Suite 110
Nampa, ID 83687
Phone
(208) 288-4700
Fax
(208) 288-4720
NPI assigned
Oct 21, 2005
Last updated
Oct 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA500 ID
Physician Assistant 363A00000X PA-500 ID Primary

Addresses

Primary practice location

4424 E Flamingo Ave
Suite 110
Nampa, ID 83687

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170

Other identifiers 5

IdentifierTypeStateIssuer
806955800MedicaidID
P00159990OtherIDRAILROAD MEDICARE
000010147756OtherIDBLUE SHIELD
PANY9OtherIDBLUE CROSS
PANZY7OtherIDBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20041001000157 ID Practitioner - Physician Assistant 8921077363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Orthopaedics LLCGroup PAC ID 8325351638, 14 clinicians

Practice addresses (Care Compare)

4842 N Cortona Way
Suite 105
Meridian, ID 83646-3171
Phone (208) 855-2410

7979 W Rifleman St
Boise, ID 83704-9066

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA500IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Orthopaedics LLC CurrentSince Apr 1, 2019 Accepting new patients
Allied Orthopaedics LLC CurrentSince Apr 1, 2019 Accepting new patients
Northwestern Neurological Assoc PC Physician Assistant Past Accepting new patients

Locations

7979 W Rifleman St
Boise, ID 83704
Phone (208) 321-4000

7979 W Rifleman St
Ste 100
Boise, ID 83704
Phone (208) 375-6133

3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567

16818 N Marketplace Blvd
Nampa, ID 83687
Phone (208) 321-4000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1114917168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 E FLAMINGO AVE",
            "address_2": "SUITE 110",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83687",
            "telephone_number": "208-288-4700",
            "fax_number": "208-288-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA500",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806955800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00159990",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010147756",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PANY9",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PANZY7",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.