Active NPI
Daviece Nickee Clement, HAIR LOSS SPECIALIST
- Prosthetics Case Management
- Richmond, VA
National Provider Identifier
1558924696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 1204020181
- Practice address
- 0 E 4TH St Ste 14B
Richmond, VA 23224-4202 - Phone
- (804) 608-9453
- NPI assigned
- Apr 15, 2019
- Last updated
- Apr 15, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 1204020181 | VA | Primary |
Addresses
Primary practice location
0 E 4TH St Ste 14B
Richmond, VA 23224-4202
Mailing address
0 E 4TH St Ste 14B
Richmond, VA 23224-4202
Phone (804) 608-9453
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S4080405-5 | Other | VA | VA STATE CORPORATION COMMISSION |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1204020181 | VA | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1558924696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "0 E 4TH ST STE 14B",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232244202",
"telephone_number": "804-608-9453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0 E 4TH ST STE 14B",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232244202",
"telephone_number": "804-608-9453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENT",
"first_name": "DAVIECE",
"middle_name": "NICKEE",
"credential": "HAIR LOSS SPECIALIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-15",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "VA",
"license": "1204020181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA STATE CORPORATION COMMISSION",
"identifier": "S4080405-5",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.