Individual provider Active NPI

Betsy F. Clemens, M.D.

  • Family Medicine Physician
  • Creve Coeur, MO
National Provider Identifier
1700850443
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
106302 Issued in MO
Practice address
450 N New Ballas Rd
Suite 266N
Creve Coeur, MO 63141-6835
Phone
(314) 991-9888
Fax
(314) 991-9886
NPI assigned
Feb 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 106302 MO Primary

Addresses

Primary practice location

450 N New Ballas Rd
Suite 266N
Creve Coeur, MO 63141-6835

Mailing address

450 N New Ballas Rd
Suite 266N
Creve Coeur, MO 63141-6835
Phone (314) 991-9888

Other identifiers 1

IdentifierTypeStateIssuer
208226903MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20070529000519 MO Practitioner - Family PracticePractitioner - Other (Physician) 2365549201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2821 N Ballas Rd
Suite 205
Saint Louis, MO 63131-2315
Phone (314) 991-9888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: betsy.clemens.1@15607.direct.athenahealth.com

Organizations & group practices 2

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1700850443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "address_2": "SUITE 266N",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416835",
            "telephone_number": "314-991-9888",
            "fax_number": "314-991-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "address_2": "SUITE 266N",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416835",
            "telephone_number": "314-991-9888",
            "fax_number": "314-991-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENS",
        "first_name": "BETSY",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-16",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "106302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208226903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.