Individual provider Active NPI

Carolyn Clem

  • Registered Nurse
  • Ashville, AL
National Provider Identifier
1366308017
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-203097 Issued in AL
Practice address
4396 Shore Dr
Ashville, AL 35953-8003
Phone
(352) 641-0255
NPI assigned
Dec 26, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-203097 AL Primary

Addresses

Primary practice location

4396 Shore Dr
Ashville, AL 35953-8003

Mailing address

4396 Shore Dr
Ashville, AL 35953-8003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1-203097ALMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1366308017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4396 SHORE DR",
            "city": "ASHVILLE",
            "state": "AL",
            "postal_code": "359538003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4396 SHORE DR",
            "city": "ASHVILLE",
            "state": "AL",
            "postal_code": "359538003",
            "telephone_number": "352-641-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-203097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; 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.