Tiffany Clemmey, FNP
Individual provider Active NPI Family Nurse Practitioner · Jacksonville, NC
NPI 1528658697 · NPPES record last updated Jan 22, 2021
Key facts
- NPI
- 1528658697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5014006 (NC)
- Practice address
- 114A Memorial Dr
Jacksonville, NC 28546-6328 - Phone
- (910) 353-0700
- NPI assigned
- Jan 22, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- North Carolina Medical School, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Riverside Physician Services Inc
Practice addresses (Care Compare)
500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2083
Hospital & facility affiliations
- Riverside Regional Medical Center
- Mary Immaculate Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230103002017 | VA | Practitioner - Nurse Practitioner | 2769899509 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Physician Services Inc | Current |
Accepting new patients | |
| Jacksonville Behavior and Mental Health | Current |
Accepting new patients | |
| Emergency Medicine Associates P.a., P.C. | Current |
Accepting new patients | |
| Emergency Medicine Associates, P.a.,P.C. | Current |
Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current |
Accepting new patients | |
| Family Care Clinic, P.a. | Past | Accepting new patients |
Locations
120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581
118 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581
15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000
8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000
856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900
500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000
1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200
Interoperability endpoints
- tclemmey266962@direct.rivhs.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5014006 | NC | Yes |
Addresses
Primary practice location
114A Memorial Dr
Jacksonville, NC 28546-6328
Mailing address
118 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 219-8326
Other providers in Jacksonville, NC
- Stacy Clark Parchman
- Makayla Clark
- Patrice Clarke
- Clear Path Counseling and Consulting LLC
- Madeline Clemens
- Clemson Sports Medicine and Rehabilitation, Inc
- Clinical Care Therapy & Wellness, PLLC
- CNC / Access, Inc.
- CNC Access Inc
- CNC Access Inc
All providers in Jacksonville, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.