Active NPI
Holly Celeste Clements, ARNP
- Family Nurse Practitioner
- Aberdeen, WA
National Provider Identifier
1366876120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60405648
- Practice address
- 954 Anderson Dr Ste 102
PMG SW Wa PRCS Aberdeen Clinic
Aberdeen, WA 98520-1001 - Phone
- (360) 533-6906
- NPI assigned
- Aug 29, 2013
- Last updated
- May 3, 2021
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60405648 | WA | Primary |
Addresses
Primary practice location
954 Anderson Dr Ste 102
PMG SW Wa PRCS Aberdeen Clinic
Aberdeen, WA 98520-1001
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455
Other practice location 1
4525 3rd Ave SE Ste 200
Lacey, WA 98503-1010
Phone (360) 754-3934
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hclements97299@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
525 Lilly Rd NE
Olympia, WA 98506-5101
954 Anderson Dr
Suite 102
Aberdeen, WA 98520-1001
Phone (360) 533-6906
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60405648 | WA | MD | Family Nurse Practitioner |
Interoperability endpoints
- hclements97299@wm.providencedirect.org
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.
-
dba Providence Medical Group SouthWest Washington
- Family Medicine Physician
- Olympia, WA
- NPI 1174744304
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Aberdeen, WA
- NPI 1154378859
-
dba Summit Pacific Medical Center
- Critical Access Hospital
- Elma, WA
- NPI 1740211028
-
dba Willapa Harbor Hospital
- Critical Access Hospital
- South Bend, WA
- NPI 1295708683
-
dba Providence St Peter Hospital
- General Acute Care Hospital
- Olympia, WA
- NPI 1346250594
-
dba Providence Centralia Hospital
- General Acute Care Hospital
- Centralia, WA
- NPI 1376624981
-
- General Acute Care Hospital
- Olympia, WA
- NPI 1619176997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1366876120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "866-747-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 ANDERSON DR STE 102",
"address_2": "PMG SW WA PRCS ABERDEEN CLINIC",
"city": "ABERDEEN",
"state": "WA",
"postal_code": "985201001",
"telephone_number": "360-533-6906"
}
],
"practiceLocations": [
{
"address_1": "4525 3rd Ave SE Ste 200",
"address_purpose": "LOCATION",
"city": "Lacey",
"state": "WA",
"postal_code": "985031010",
"country_code": "US",
"telephone_number": "360-754-3934",
"fax_number": "360-943-8023",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEMENTS",
"first_name": "HOLLY",
"middle_name": "CELESTE",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60405648",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hclements97299@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4525 3rd Ave SE Ste 200",
"city": "Lacey",
"state": "WA",
"country_code": "US",
"postal_code": "985031010",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Aberdeen, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.