Organization Active NPI

Sudie M Clem LLC

  • Clinical Social Worker
  • Greenwood, SC
National Provider Identifier
1225556590
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5617 Issued in SC
Legal business name
SUDIE M CLEM LLC
Practice address
112 Bypass 225
Greenwood, SC 29646
Phone
(864) 344-3484
Fax
(864) 977-3480
NPI assigned
Sep 6, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Sudie Moore Clem, LISW-CPNPI 1336331743
Title
Owner/Provider
Phone
(864) 344-3484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5617 SC Primary

Addresses

Primary practice location

112 Bypass 225
Greenwood, SC 29646

Mailing address

112 Bypass 225
Greenwood, SC 29646-1154
Phone (864) 344-3484

Other practice location 1

201 Hampton Ave Ste F
Greenwood, SC 29646-2271
Phone (864) 344-3484

Other practice location 2

201 Hampton Ave Ste F
Greenwood, SC 29646-2271
Phone (864) 344-3484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020003063 SC Part B Supplier - Clinic/Group Practice 7517233463 Receives reassigned benefits from 1 practitioner
Practice locations: Greenwood, SC

National Provider Directory

National Provider Directory

Locations

112 Bypass 225
Greenwood, SC 29646
Phone (864) 344-3484

201 Hampton Ave
Ste F
Greenwood, SC 29646
Phone (864) 344-3484

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225556590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BYPASS 225",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296461154",
            "telephone_number": "864-344-3484",
            "fax_number": "864-977-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BYPASS 225",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-344-3484",
            "fax_number": "864-977-3480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Hampton Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296462271",
            "country_code": "US",
            "telephone_number": "864-344-3484",
            "fax_number": "864-942-0106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Hampton Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296462271",
            "country_code": "US",
            "telephone_number": "864-344-3484",
            "fax_number": "864-942-0106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUDIE M CLEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CLEM",
        "authorized_official_first_name": "SUDIE",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "864-344-3484",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "5617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.