Individual provider Active NPI

Allison Clemmer

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1366220832
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
101 Elm Ave SE
Roanoke, VA 24013-2222
Phone
(540) 831-1684
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

101 Elm Ave SE
Roanoke, VA 24013-2222

Mailing address

5041 Pleasant Hill Dr
Roanoke, VA 24018-3457
Phone (970) 396-2902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20240214001240 VA Practitioner - Physician Assistant 7719321173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Roanoke Valley ENT and Allergy PCGroup PAC ID 6305199324, 5 clinicians

Practice addresses (Care Compare)

4633 Brambleton Ave
Suite 100
Roanoke, VA 24018-3410
Phone (540) 968-7368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1366220832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 PLEASANT HILL DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183457",
            "telephone_number": "970-396-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELM AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240132222",
            "telephone_number": "540-831-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMER",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.