Kristin Marie Clemens, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AC003082 Issued in MD

Practice address

800 S Frederick Ave Ste 200a
Gaithersburg, MD 20877-4152

Phone

(877) 588-0282

Fax

(301) 880-0228

NPI assigned

Jan 15, 2020

Last updated

May 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Right Solutions Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gaithersburg, MD
  • NPI 1881215580

  DC

  Medicare reassignment NPD Authorized official
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1154961381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 BARON KENT LN",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203438",
            "telephone_number": "877-588-0282",
            "fax_number": "301-880-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S FREDERICK AVE STE 200A",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774152",
            "telephone_number": "877-588-0282",
            "fax_number": "301-880-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC003082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100148709",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Chiropractic Center PC
• Clark Chiropractic Center, Inc.
• Gary E. Clark, LCPC
• Denaye Armani Clary
• Classical Acupuncture
• Renelle Sandy Clerzias
• Frania Climaco, LICSW
• Nikolas Michael Cline
• Eboni Clipper, LCPC
• Raquel Coale, LCPC

• Psychiatric/Mental Health Nurse Practitioner in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.