Active NPI
Parker Wayne Clement
- Anatomic Pathology & Clinical Pathology Physician
- Boulder, CO
National Provider Identifier
1376809442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 40539
- Practice address
- 4747 Arapahoe Ave
Boulder, CO 80303-1131 - Phone
- (303) 415-7000
- NPI assigned
- Apr 3, 2012
- Sex
- Male
- Sole proprietor
- No
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Boulder, CO
- NPI 1205897220
Anatomic Pathology & Clinical Pathology, CO
Hospital & facility affiliations 61
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Sleep Disorder Diagnostic Clinic/Center
- Boulder, CO
- NPI 1093357907
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- University of Tennessee, HSC, College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Boulder Valley Pathology P C
Practice addresses (Care Compare)
4747 Arapahoe Ave
Boulder, CO 80303-1131
Phone (720) 854-7000
Hospital & facility affiliations
- Boulder Community Health
- University of Colorado Hospital Authority
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180516001253 | CO | Practitioner - Pathology | 7719251883 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40539 | SC | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boulder Valley Pathology P C | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000
42 Garden Ctr
Broomfield, CO 80020
36 Garden Ctr
Broomfield, CO 80020
Phone (303) 465-0401
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 40539 | SC | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
4747 Arapahoe Ave
Boulder, CO 80303-1131
Mailing address
42 Garden Ctr
Broomfield, CO 80020-1730
Phone (303) 465-0401
Other practice location 1
University Hospital
Salt Lake City, UT 84132-0001
Phone (801) 587-4281
Other practice location 2
5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-7011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2021.
{
"created_epoch": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615766400000",
"number": "1376809442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 GARDEN CTR",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201730",
"telephone_number": "303-465-0401",
"fax_number": "303-438-1351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 ARAPAHOE AVE",
"city": "BOULDER",
"state": "CO",
"postal_code": "803031131",
"telephone_number": "303-415-7000"
}
],
"practiceLocations": [
{
"address_1": "University Hospital",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841320001",
"country_code": "US",
"telephone_number": "801-587-4281",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Richland Medical Park Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292036863",
"country_code": "US",
"telephone_number": "803-434-7011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEMENT",
"first_name": "PARKER",
"middle_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-03",
"last_updated": "2021-03-15",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "SC",
"license": "40539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.