Individual provider Active NPI

Callie Clement, NP

  • Family Nurse Practitioner
  • Gadsden, AL
National Provider Identifier
1790486512
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-130866 Issued in AL
Practice address
713 Goodyear Ave
Gadsden, AL 35903-1156
Phone
(256) 492-4040
NPI assigned
Mar 17, 2023
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 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 1-130866 AL Primary

Addresses

Primary practice location

713 Goodyear Ave
Gadsden, AL 35903-1156

Mailing address

155 Jessie Rd
Boaz, AL 35957-5884
Phone (256) 744-5515

Other practice location 1

301 Medical Center Dr SW
Fort Payne, AL 35968-3420
Phone (256) 492-4040

Other practice location 2

9524 US Highway 431
Albertville, AL 35950-0106
Phone (256) 492-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230509001393 AL Practitioner - Nurse Practitioner 9537525928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

713 Goodyear Ave
Gadsden, AL 35903-1156
Phone (256) 492-4040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-130866ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Urology Associates, P.C. CurrentSince Aug 6, 2023 Accepting new patients
Clinical Urology Associates, P.C. CurrentSince Aug 6, 2023 Accepting new patients
Cilinical Urology Associates, P.C. Past Accepting new patients

Locations

9524 US Highway 431
Albertville, AL 35950

2001 Cades Ave SW
Fort Payne, AL 35968
Phone (256) 492-7404

301 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-0141

713 Goodyear Ave
Gadsden, AL 35903
Phone (256) 492-4017

1475 1st Ave SW
Jacksonville, AL 36265
Phone (256) 435-9386

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1790486512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 JESSIE RD",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575884",
            "telephone_number": "256-744-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 GOODYEAR AVE",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031156",
            "telephone_number": "256-492-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Medical Center Dr SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683420",
            "country_code": "US",
            "telephone_number": "256-492-4040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9524 US Highway 431",
            "address_purpose": "LOCATION",
            "city": "Albertville",
            "state": "AL",
            "postal_code": "359500106",
            "country_code": "US",
            "telephone_number": "256-492-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "CALLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-130866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.