Organization Active NPI

Bethesda Clinic, LLC

  • Primary Care Clinic/Center
  • Clifton, TN
National Provider Identifier
1417505108
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BETHESDA CLINIC, LLC
Practice address
124 Main St
Clifton, TN 38425-5544
Phone
(931) 676-5200
Fax
(931) 676-5202
NPI assigned
Aug 27, 2019
Last updated
Oct 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Authorized official

Name
Allison Jessica Sems, PA-CNPI 1669792172
Title
Owner
Phone
(931) 676-7367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

124 Main St
Clifton, TN 38425-5544

Mailing address

118 Scenic Dr
Clifton, TN 38425-5333
Phone (931) 676-7367

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201007002846 TN Part B Supplier - Clinic/Group Practice 1153742374 Receives reassigned benefits from 2 practitioners
Practice locations: Clifton, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2175658Bethesda Clinic, LLC124 Main Street, Clifton, TN 38425Provider-performed microscopyNov 25, 2027

National Provider Directory

National Provider Directory

Locations

124 Main St
Clifton, TN 38425
Phone (931) 676-5200

312 Main St
Clifton, TN 38425

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696550400000",
    "number": "1417505108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SCENIC DR",
            "city": "CLIFTON",
            "state": "TN",
            "postal_code": "384255333",
            "telephone_number": "931-676-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "city": "CLIFTON",
            "state": "TN",
            "postal_code": "384255544",
            "telephone_number": "931-676-5200",
            "fax_number": "931-676-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A",
        "authorized_official_last_name": "SEMS",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-676-7367",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.