Shanequia Deshawn Clemons

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

2180 Reese St
Lackland Afb, TX 78236-1042

Phone

(305) 912-3482

NPI assigned

Dec 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Shanequia Nicki Clemons Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Neuro Psychiatric & Behavioral Rehabilitation Practitioners Associatio

  • Behavioral Neurology & Neuropsychiatry Physician
  • San Antonio, TX
  • NPI 1699241513
  NPD Authorized official
• Pursuit of Seduction, Inc.

  • Community/Behavioral Health Agency
  • Tomball, TX
  • NPI 1871068635
  NPD

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1831605765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 REESE ST",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782361042",
            "telephone_number": "210-606-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 REESE ST",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "782361042",
            "telephone_number": "305-912-3482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "SHANEQUIA",
        "middle_name": "DESHAWN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANEQUIA",
            "last_name": "CLEMONS",
            "middle_name": "NICKI",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nathan Cecava, MD
• Elizabeth Marie Cervantes, RBT
• Patricia Escareno Cervantes, COA
• Wayne Clark Cheatum, R. PH.
• John D. Childs, PT, PHD, OCS, FAAOMP
• Herman Shermaine Clincy Jr., HEALH SERVICES TECH
• Margaret Bonnie Cole, PHARM.D.
• Paula Corrigan
• Laura Cosimi, MD
• Chantal Cousineau-Krieger, M.D.

• Rehabilitation Practitioner in Lackland Afb, TX
• Providers in Lackland Afb, TX by specialty
• Rehabilitation Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.