Active NPI
Charles Clem Jr., OTD, OTR
- Occupational Therapist
- Greenwood, IN
National Provider Identifier
1518556471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31006651A
- Practice address
- 3000 S State Road 135
Greenwood, IN 46143-9825 - Phone
- (317) 497-6000
- NPI assigned
- Jan 14, 2021
- Last updated
- Jan 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31006651A | IN | Primary |
Addresses
Primary practice location
3000 S State Road 135
Greenwood, IN 46143-9825
Mailing address
3000 S State Road 135
Greenwood, IN 46143-9825
Phone (317) 497-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31006651A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1518556471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 S STATE ROAD 135",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461439825",
"telephone_number": "317-497-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 S STATE ROAD 135",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461439825",
"telephone_number": "317-497-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEM",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "OTD, OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006651A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.