Individual provider Active NPI

Barbara Jean Clem, MSN- FNP

  • Family Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1740560317
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28086951A Issued in IN
Practice address
808 N 3Rd St
Goshen, IN 46528-7100
Phone
(574) 534-0088
Fax
(574) 971-8434
NPI assigned
Aug 26, 2011
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28086951A IN Primary

Addresses

Primary practice location

808 N 3Rd St
Goshen, IN 46528-7100

Mailing address

213 Middlebury St
Goshen, IN 46528-2956
Phone (574) 534-3300

Other identifiers 1

IdentifierTypeStateIssuer
201063690MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bclem299534@direct.ochin.org Direct

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
Master of Science - Nursing, Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1740560317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MIDDLEBURY ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465282956",
            "telephone_number": "574-534-3300",
            "fax_number": "574-534-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 3RD ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287100",
            "telephone_number": "574-534-0088",
            "fax_number": "574-971-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "credential": "MSN- FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28086951A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201063690",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bclem299534@direct.ochin.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "808 N 3rd St",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465287100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.