Zackary Clemons

Primary specialty

ContractorTaxonomy code 171W00000X

License

056780190 Issued in GA

Practice address

220 Ben Burton Cir Ste Aandb
Bogart, GA 30622-6851

Phone

(678) 942-6334

Fax

(706) 243-4760

NPI assigned

Nov 8, 2013

Last updated

Jul 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Halifax EMS LLC

  • Land Ambulance
  • Bogart, GA
  • NPI 1396336517
  NPD Authorized official
• Solutions Medical Transport

  • Non-emergency Medical Transport (VAN)
  • Jefferson, GA
  • NPI 1710378963
  NPD Authorized official

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1205265246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 JONES RD",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305493183",
            "telephone_number": "678-942-6334",
            "fax_number": "706-757-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BEN BURTON CIR STE AANDB",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306226851",
            "telephone_number": "678-942-6334",
            "fax_number": "706-243-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "ZACKARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-08",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": "056780190",
            "primary": true
        },
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": "GA",
            "license": "0567890190",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "GA",
            "license": "056780190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Brown, OTD, OTR/L
• Dennis Caughy, L.C.S.W.
• Celestial Healhcare Services
• Bum Mo Chung, DMD
• Clarke County Dept of Family and Children Services
• James Michael Cobb, M.D.
• Nickie Cole
• Collaborative Relationship Therapy, LLC
• Tamara Collins
• Catherine Colquitt, MS, ATC, LAT

• Contractor in Bogart, GA
• Providers in Bogart, GA by specialty
• Contractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.