Individual provider Active NPI

Javier L Clemente, MD

  • Nephrology Specialist/Technologist
  • Cleveland, OH
National Provider Identifier
1245331511
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology Specialist/TechnologistTaxonomy code 246ZN0300X
License
35041323 Issued in OH
Practice address
18099 Lorain Rd
Ste 316
Cleveland, OH 44135
Phone
(216) 671-2322
Fax
(216) 671-0140
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Specialist/Technologist 246ZN0300X 35041323 OH Primary

Addresses

Primary practice location

18099 Lorain Rd
Ste 316
Cleveland, OH 44135

Mailing address

18099 Lorain Ave
Ste 316
Cleveland, OH 44111
Phone (216) 671-2322

Other identifiers 4

IdentifierTypeStateIssuer
12812OtherQUALCHOICE
0366223MedicaidOH
0560460014OtherBWC
000000130134OtherANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35041323OHMDNephrology Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245331511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18099 LORAIN AVE",
            "address_2": "STE 316",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44111",
            "telephone_number": "216-671-2322",
            "fax_number": "216-671-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18099 LORAIN RD",
            "address_2": "STE 316",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44135",
            "telephone_number": "216-671-2322",
            "fax_number": "216-671-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "JAVIER",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZN0300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Nephrology",
            "state": "OH",
            "license": "35041323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "12812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0366223",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "0560460014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000130134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.