Active NPI
John B. Clemmons, Jr., M.D., P.a.
- Gastroenterology Physician
- Houston, TX
National Provider Identifier
1578862959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G0677
- Legal business name
- JOHN B. CLEMMONS, JR., M.D., P.A.
- Practice address
- 1213 Hermann Dr Ste 220
Houston, TX 77004-7009 - Phone
- (713) 528-6562
- Fax
- (713) 528-1045
- NPI assigned
- Mar 24, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John Clemmons Jr.
- Title
- Owner/Physician
- Phone
- (713) 528-6562
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G0677 | TX | Primary |
Addresses
Primary practice location
1213 Hermann Dr Ste 220
Houston, TX 77004-7009
Mailing address
1213 Hermann Dr Ste 220
Houston, TX 77004-7009
Phone (713) 528-6562
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035370801 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1213 Hermann Dr
Ste 420
Houston, TX 77004
Phone (713) 528-6562
Interoperability endpoints
- https://api.platform.athenahealth.com/23633/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Houston, TX
- NPI 1518997477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644278400000",
"number": "1578862959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 HERMANN DR STE 220",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770047009",
"telephone_number": "713-528-6562",
"fax_number": "713-528-1045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 HERMANN DR STE 220",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770047009",
"telephone_number": "713-528-6562",
"fax_number": "713-528-1045"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHN B. CLEMMONS, JR., M.D., P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2011-03-24",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A",
"authorized_official_last_name": "CLEMMONS",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "OWNER/PHYSICIAN",
"authorized_official_telephone_number": "713-528-6562",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "G0677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035370801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.