Individual provider Active NPI

Joseph William Clemmons, P.A.

  • Surgical Physician Assistant
  • Columbus, GA
National Provider Identifier
1447312400
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1538 Issued in GA
Practice address
1538 13TH. Ave
Suite B300
Columbus, GA 31901-3700
Phone
(706) 321-9300
Fax
(706) 321-9384
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1538 GA Primary
Physician Assistant 363A00000X 001538 GA

Addresses

Primary practice location

1538 13TH. Ave
Suite B300
Columbus, GA 31901-3700

Mailing address

1538 13TH. Ave
Suite B300
Columbus, GA 31901-3700
Phone (706) 321-9300

Other identifiers 1

IdentifierTypeStateIssuer
100001103DMedicaidGA

Medicare participation

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

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
77.61
Promoting interoperability
99
Improvement activities
40
Cost
72.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1538GAMDCritical Care Registered Respiratory Therapist
001538GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1447312400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 13TH. AVE",
            "address_2": "SUITE B300",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013700",
            "telephone_number": "706-321-9300",
            "fax_number": "706-321-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 13TH. AVE",
            "address_2": "SUITE B300",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013700",
            "telephone_number": "706-321-9300",
            "fax_number": "706-321-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "1538",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "001538",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001103D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.