Active NPI
Haley Clements
- Nurse Practitioner
- Eufaula, AL
National Provider Identifier
1295143733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1-103042
- Practice address
- 23 Veteran's Boulevard
Eufaula, AL 36027-4444 - Phone
- (334) 687-8051
- Fax
- (334) 687-0470
- NPI assigned
- Jul 29, 2014
- Last updated
- May 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-103042 | AL | Primary |
Addresses
Primary practice location
23 Veteran's Boulevard
Eufaula, AL 36027-4444
Mailing address
1414 Elba Hwy
Troy, AL 36079-6020
Phone (334) 670-6726
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-103042 | Other | AL | STATE LICENSE |
| 163453 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Clinic PC | Nurse Practitioner | Current | Accepting new patients |
Locations
201 Doctors Dr
Dothan, AL 36301
Phone (334) 794-6611
Interoperability endpoints
- hclements@yourcarecommunity.org
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1720
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494806400000",
"number": "1295143733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 ELBA HWY",
"city": "TROY",
"state": "AL",
"postal_code": "360796020",
"telephone_number": "334-670-6726",
"fax_number": "334-670-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 VETERAN'S BOULEVARD",
"city": "EUFAULA",
"state": "AL",
"postal_code": "360274444",
"telephone_number": "334-687-8051",
"fax_number": "334-687-0470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENTS",
"first_name": "HALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-29",
"last_updated": "2017-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "1-103042",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "1-103042",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163453",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eufaula, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; 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.