Rebecca Black Clements, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

67547 Issued in GA

Practice address

3400A Old Milton Parkway
Suite 330
Alpharetta, GA 30005

Phone

(770) 751-6111

Fax

(770) 772-6099

NPI assigned

Jun 23, 2009

Last updated

Apr 3, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: prestonridgepediatrics.rebeccaclements@129069.advancedmd-direct.com

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.

• Preston Ridge Pediatric Associates, PC

  • Pediatrics Physician
  • Alpharetta, GA
  • NPI 1427048685
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1487882916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400A OLD MILTON PARKWAY",
            "address_2": "SUITE 330",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-751-6111",
            "fax_number": "770-772-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400A OLD MILTON PARKWAY",
            "address_2": "SUITE 330",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-751-6111",
            "fax_number": "770-772-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "REBECCA",
        "middle_name": "BLACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "003587",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "67547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda A Clarkson, LPC
• Toya G Claxton, CSA
• Kawami R. Clay, M.D.
• Virginia Cleere
• Ruth P Clemens, MD
• Caroline Clerisme, D.M.D.
• Darmanyce Cleveland
• Cloud 10 Solutions LLC
• Jennifer Cloy, RPH
• CNH1 LLC

• Pediatrics Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.