Active NPI
David J Clemons, MD
- Dermatology Physician
- Shreveport, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 014569
- Practice address
- 845 Olive St
Shreveport, LA 71104-2101 - Phone
- (318) 222-3278
- Fax
- (318) 421-3155
- NPI assigned
- Nov 29, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 014569 | LA | Primary |
Addresses
Primary practice location
845 Olive St
Shreveport, LA 71104-2101
Mailing address
845 Olive St
Shreveport, LA 71104-2101
Phone (318) 222-3278
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1318680 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Louisiana State University School of Medicine in Shreveport, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9007 Ellerbe Rd
Shreveport, LA 71106-6724
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 109 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 2006 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 95 |
| Skin biopsy | 95 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014569 | LA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology and Skin Surgery Apmc | Dermatology | Current | Accepting new patients |
Locations
845 Olive St
Shreveport, LA 71104
Phone (318) 222-3278
9007 Ellerbe Rd
Shreveport, LA 71106
Phone (318) 222-3278
Interoperability endpoints
- dclemons@dermatologyskinsurgery.emadirect.md
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.
-
- Dermatology Physician
- Shreveport, LA
- NPI 1023005758
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba WK Bossier Health Center
- General Acute Care Hospital
- Bossier City, LA
- NPI 1003968579
-
dba Willis Knighton South Hospital
- General Acute Care Hospital
- Shreveport, LA
- NPI 1124170691
-
dba WK Pierremont Health Center
- General Acute Care Hospital
- Shreveport, LA
- NPI 1275685539
-
- General Acute Care Hospital
- Shreveport, LA
- NPI 1568461572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1306829916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 OLIVE ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042101",
"telephone_number": "318-222-3278",
"fax_number": "318-421-3155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "845 OLIVE ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711042101",
"telephone_number": "318-222-3278",
"fax_number": "318-421-3155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMONS",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "LA",
"license": "014569",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1318680",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.