Amanda Cathleen Clemmons, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

301776 Issued in LA

Practice address

602 N 39TH Ave Ste 200
Yakima, WA 98902-6398

Phone

(877) 522-1275

Fax

(833) 888-7145

NPI assigned

Jun 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Ideal Option, PLLC

  • Clinic/Center
  • Kennewick, WA
  • NPI 1457788275
  Medicare reassignment NPD
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Renton, WA
  • NPI 1346754868
  Medicare reassignment
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Kennewick, WA
  • NPI 1841648623
  NPD
• Bicycle Health Medical Group PA

  • Addiction Medicine (Family Medicine) Physician
  • Seattle, WA
  • NPI 1194342162
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1437564408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 TULANE AVE",
            "address_2": "SUITE 500",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701194100",
            "telephone_number": "504-821-2601",
            "fax_number": "504-267-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N 39TH AVE STE 200",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026398",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "AMANDA",
        "middle_name": "CATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "301776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449621",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Robert Clark, PHARM D
• Carolynn Kathleen Clarke, CNM, MSN, RN
• Kirsten Oversby Clarke, DPT
• Sean F Cleary, MD
• Michael Clement, MS, CDP
• Kimberly Clemmons, LICSW
• Clinic for Ear Nose Throat Head & Neck Medicine & Surgery P S (Otolaryngology Clinic)
• Alyssa Closner, RN
• Courtney A Cobane, OT
• Caroline Cobb, ARNP

• Physician Assistant in Yakima, WA
• Providers in Yakima, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.