Lisa Erin Clemente, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

601 W 2ND St
Bloomington, IN 47403-2317

Phone

(812) 353-9515

Fax

(812) 353-9275

NPI assigned

Jun 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Washington Hospital Center Corp

  • Neurological Surgery Physician
  • Washington, DC
  • NPI 1407870124
  Medicare reassignment
• Washington Hospital Center Corp

  • General Practice Physician
  • Washington, DC
  • NPI 1629394424
  NPD
• Indiana University Health Southern Indiana Physicians, Inc

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1548519572
  NPD (past)
• Medlantic Healthcare Group

  • Emergency Medicine Physician
  • Baltimore, MD
  • NPI 1467408450
  NPD (past)
• Providence Health Services Inc

  • Family Medicine Physician
  • Washington, DC
  • NPI 1669453809
  NPD (past)

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1255694212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021149",
            "telephone_number": "812-353-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032317",
            "telephone_number": "812-353-9515",
            "fax_number": "812-353-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "LISA",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-24",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Oliver Clay, RBT
• Jennifer Claypoole
• Susan Beth Clearwater, R.N., B.S.N.
• Clematis Bloom Therapy LLC
• Adam Brian Clemens, ATC
• Andrew Clemons, RBT
• Rachel Clidienst, RBT
• Madelyn Cline
• Marjorie Ann Clouse, RN, CEN, SANE-A
• Dori Clousing

• Medical Physician Assistant in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.