Roger Fair Clem, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

3510 Issued in GA

Practice address

140 Battlewood Dr
Fort Oglethorpe, GA 30742-4006

Phone

(706) 861-7070

NPI assigned

Mar 7, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Erdman ENT, PC

  • Otolaryngology Physician
  • Fort Oglethorpe, GA
  • NPI 1376932327
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457481491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 LAKE MARINA DR",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434661",
            "telephone_number": "423-877-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BATTLEWOOD DR",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424006",
            "telephone_number": "706-861-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "ROGER",
        "middle_name": "FAIR",
        "name_prefix": "Mr.",
        "credential": "CCC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "3510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Fort Oglethorpe, GA
• Providers in Fort Oglethorpe, GA by specialty
• Audiologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.