Individual provider Active NPI

Alexandria S Clemmons, MD

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1699522698
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1411 E 31St St FL 2
Oakland, CA 94602-1018
Phone
(510) 437-5039
Fax
(510) 535-7313
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1411 E 31St St FL 2
Oakland, CA 94602-1018

Mailing address

1411 E 31St St FL 2
Oakland, CA 94602-1018
Phone (510) 437-5039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820004017 NC Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 1355841826

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1699522698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST FL 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-5039",
            "fax_number": "510-535-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST FL 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021018",
            "telephone_number": "510-437-5039",
            "fax_number": "510-535-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "ALEXANDRIA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "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 Oakland, CA

Sources for this page

Verify at the official NPI Registry.