Active NPI
James Kenneth Clemons, MS LPC
- Foster Care Agency
- Lawton, OK
National Provider Identifier
1639400484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- License
- 425
- Practice address
- 2725 NE Euclid Ave
Lawton, OK 73507-7147 - Phone
- (580) 704-5575
- Fax
- (580) 585-6436
- NPI assigned
- Jan 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | 425 | OK | Primary |
Addresses
Primary practice location
2725 NE Euclid Ave
Lawton, OK 73507-7147
Mailing address
2725 NE Euclid Ave
Lawton, OK 73507-7147
Phone (580) 704-5575
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100803130 C | Medicaid | OK |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 425 | OK | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1639400484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 NE EUCLID AVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735077147",
"telephone_number": "580-704-5575",
"fax_number": "580-585-6436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2725 NE EUCLID AVE",
"city": "LAWTON",
"state": "OK",
"postal_code": "735077147",
"telephone_number": "580-704-5575",
"fax_number": "580-585-6436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMONS",
"first_name": "JAMES",
"middle_name": "KENNETH",
"credential": "MS LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-19",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": "OK",
"license": "425",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100803130 C",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.