Carrie A Clemens, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110002304 Issued in VA

Practice address

100 Sentara Cir
Williamsburg, VA 23188-5713

Phone

(757) 984-6000

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carrie.clemens.1@17374.direct.athenahealth.com

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.

• One Hampton Medical, LLC

  • Emergency Medicine Physician
  • Mechanicsville, VA
  • NPI 1366888224

  Physician Assistant

  NPD (past)
• Riverside Emergency Physicians LLP

  • Emergency Medicine Physician
  • Gloucester, VA
  • NPI 1609891746

  Physician Assistant

  NPD (past)
• Riverside Physician Services, Inc.

  • Emergency Medicine Physician
  • Newport News, VA
  • NPI 1487771655
  NPD (past)
• Virginia Emergency Group LLC

  • Emergency Medicine Physician
  • Petersburg, VA
  • NPI 1487816369
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1164469896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BULIFANTS BLVD STE B",
            "address_2": "T-SYSTEM WILLIAMSBURG",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SENTARA CIR",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885713",
            "telephone_number": "757-984-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "CARRIE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110002304",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002304",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164469896",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11765311",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Meredith Clay, DPM
• Lisa Ann Clay, L.P.T.A.
• Clayton Counseling LLC
• Jonathan Norman Clayton, LPC
• Sarah Elizabeth Clayton, LPC
• CMCP-Williamsburg, LLC
• Coastal Counseling Center of Tidewater
• Coastal Oral Maxillofacial Surgery & Implants, Inc.
• Coastal Oral Surgery
• Coastal Virginia Sleep Solutions PLLC

• Surgical Physician Assistant in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.