Tatisha Clemons

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

10507 S Western Ave
Chicago, IL 60643-2527

Phone

(773) 425-4702

Fax

(773) 634-8092

NPI assigned

Apr 29, 2016

Last updated

May 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Express Charter, LLC

  • Non-emergency Medical Transport (VAN)
  • Chicago, IL
  • NPI 1295185833
  NPD (past) Authorized official

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1265887939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10507 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432527",
            "telephone_number": "773-425-4702",
            "fax_number": "773-634-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10507 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432527",
            "telephone_number": "773-425-4702",
            "fax_number": "773-634-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "TATISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7666510",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack D Clemis, M.D.
• Jalen David Clemmons, MSW, LCSW
• Margaret Clemons-Adams, APRN
• Chanel Clemons, LPC
• Katelyn Clemons
• Alden Clendenin, DC, CCSP
• Courtney Marie Clennon, MS
• Renee Ann Clerkin, R.D.
• Ashley Cleveland
• Beatrice Hyde Cleveland, LCSW

• Non-emergency Medical Transport (VAN) in Chicago, IL
• Providers in Chicago, IL by specialty
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.