Active NPI
Claire Clemons, SLP- CCC
- Speech-Language Pathologist
- Texarkana, TX
National Provider Identifier
1669825360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#4026
- Practice address
- 124 Quail Brook Dr
Texarkana, TX 75501-2179 - Phone
- (405) 471-2272
- NPI assigned
- Jul 18, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#4026 | AR | Primary |
Addresses
Primary practice location
124 Quail Brook Dr
Texarkana, TX 75501-2179
Mailing address
124 Quail Brook Dr
Texarkana, TX 75501-2179
Phone (405) 471-2272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 213976721 | Medicaid | AR |
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 |
|---|---|---|---|
| SP#4026 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Temple Memorial Pediatric Center Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Texarkana, TX
- NPI 1972654663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468800000000",
"number": "1669825360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 QUAIL BROOK DR",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755012179",
"telephone_number": "405-471-2272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 QUAIL BROOK DR",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755012179",
"telephone_number": "405-471-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMONS",
"first_name": "CLAIRE",
"credential": "SLP- CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-18",
"last_updated": "2016-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#4026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "213976721",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.