Individual provider Active NPI

McCoy Clementson, DO

  • Student in an Organized Health Care Education/Training Program
  • Corpus Christi, TX
National Provider Identifier
1689429029
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
600 Elizabeth St # 9B
Corpus Christi, TX 78404-2235
Phone
(361) 881-3000
NPI assigned
Apr 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X W4074 TX
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

600 Elizabeth St # 9B
Corpus Christi, TX 78404-2235

Mailing address

600 Elizabeth St # 9B
Corpus Christi, TX 78404-2235
Phone (361) 881-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Emergency Physicians, PLLCGroup PAC ID 6204280480, 108 clinicians

Practice addresses (Care Compare)

2500 E Main St
Alice, TX 78332-4261
Phone (361) 661-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
W4074TXMDEmergency Medicine Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1689429029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST # 9B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-881-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST # 9B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-881-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTSON",
        "first_name": "MCCOY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-19",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "W4074",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.