Active NPI
Jordan D Clement, DO
- Pediatrics Physician
- Moses Lake, WA
National Provider Identifier
1780375246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- OP.70058514
- Practice address
- 840 E Hill Ave
Moses Lake, WA 98837-2238 - Phone
- (509) 764-7400
- Fax
- (509) 764-6437
- NPI assigned
- May 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | OP.70058514 | WA | Primary |
Addresses
Primary practice location
840 E Hill Ave
Moses Lake, WA 98837-2238
Mailing address
840 E Hill Ave
Moses Lake, WA 98837-2238
Phone (509) 764-7400
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260624000071 | WA | Practitioner - Pediatric Medicine | 8123488590 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
820 N Chelan Ave
Wenatchee, WA 98801-2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1780375246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 E HILL AVE",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372238",
"telephone_number": "509-764-7400",
"fax_number": "509-764-6437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 E HILL AVE",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372238",
"telephone_number": "509-764-7400",
"fax_number": "509-764-6437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENT",
"first_name": "JORDAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-16",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "OP.70058514",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/",
"affiliation": "N",
"address_1": "820 N Chelan Ave",
"city": "Wenatchee",
"state": "WA",
"country_code": "US",
"postal_code": "988012028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Moses Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.