Active NPI
Nicole Whitman Clements, PA-C
- Physician Assistant
- Albuquerque, NM
National Provider Identifier
1720590284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2019-0003
- Practice address
- 301 Unser Blvd NW
Albuquerque, NM 87121 - Phone
- (505) 925-4126
- Fax
- (505) 925-4721
- NPI assigned
- Oct 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | TX | ||
| Physician Assistant | 363A00000X | PA2019-0003 | NM | Primary |
Addresses
Primary practice location
301 Unser Blvd NW
Albuquerque, NM 87121
Mailing address
933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106-4375
Phone (505) 272-3120
Other practice location 1
913 S Main St
Del Rio, TX 78840-5807
Phone (830) 774-4363 ext. 3010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TEMPORARY | Other | TX | TEXAS PHYSICIAN ASSISTANT BOARD |
Other names 1
- Nicole Whitman Seeger
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2019-0003 | NM | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550016000000",
"number": "1720590284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE STE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064375",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 UNSER BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87121",
"telephone_number": "505-925-4126",
"fax_number": "505-925-4721"
}
],
"practiceLocations": [
{
"address_1": "913 S Main St",
"address_purpose": "LOCATION",
"city": "Del Rio",
"state": "TX",
"postal_code": "788405807",
"country_code": "US",
"telephone_number": "830-774-4363 x3010",
"fax_number": "830-774-0890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLEMENTS",
"first_name": "NICOLE",
"middle_name": "WHITMAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-24",
"last_updated": "2019-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "PA2019-0003",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS PHYSICIAN ASSISTANT BOARD",
"identifier": "TEMPORARY",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "SEEGER",
"middle_name": "WHITMAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.