Charles D Clemetson, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

013808 Issued in ME

Practice address

39 Foreside Rd
Portland, ME 04110-1405

Phone

(207) 415-2700

Fax

(207) 899-0138

NPI assigned

Feb 17, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Martha & Company, LLC

  • Mastectomy Fitter
  • Yarmouth, ME
  • NPI 1326681305
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1649448267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FORESIDE RD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041101405",
            "telephone_number": "207-415-2700",
            "fax_number": "207-899-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FORESIDE RD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041101405",
            "telephone_number": "207-415-2700",
            "fax_number": "207-899-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMETSON",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-17",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "013808",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "ME",
            "license": "013808",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Cleary
• Miles Patrick Cleary, LCSW
• Cassie Clement, M.A. CCC-SLP
• Lindsey Clement, NP
• Clementine Maine ABA LLC
• Elizabeth Jane Clemetson, MD
• Emily Clemetson, M.D.
• Laura Cleumas, M.S. CCC-SLP
• Elizabeth Clifford, PMHNP-BC
• Clinical Counseling Associates of Maine, P.a.

• All providers in Portland, ME
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.