Individual provider Active NPI

Rod Santiago Clamonte Jr.

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1871958736
Registry record updated Dec 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003578 Issued in CA
Practice address
2615 Chester Ave
Bakersfield, CA 93301-2014
Phone
(661) 395-3000
NPI assigned
Dec 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2015

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 95003578 CA Primary

Addresses

Primary practice location

2615 Chester Ave
Bakersfield, CA 93301-2014

Mailing address

10007 Saint Albans Ave
Bakersfield, CA 93311-9033

Other names 1

  • Mr. Rodanim Santiago Clamonte Jr. Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160203001408 CA Practitioner - Nurse Practitioner 4385948876 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003578CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Urgent Care Inc. CurrentSince Sep 1, 2017 Accepting new patients
Kern County Hospital Authority CurrentSince Jan 17, 2018 Accepting new patients
Emergency Physicians Urgent Care Inc. CurrentSince Sep 1, 2017 Accepting new patients
Kern County Hospital Authority CurrentSince Jan 17, 2018 Accepting new patients

Locations

212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060

9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 331-8640

4871 White Ln
Bakersfield, CA 93309
Phone (661) 832-1679

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

1111 Columbus St
Bakersfield, CA 93305
Phone (661) 326-5052

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1450483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450483200000",
    "number": "1871958736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10007 SAINT ALBANS AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933119033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CHESTER AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012014",
            "telephone_number": "661-395-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAMONTE",
        "first_name": "ROD",
        "middle_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-19",
        "last_updated": "2015-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODANIM",
            "last_name": "CLAMONTE",
            "middle_name": "SANTIAGO",
            "prefix": "MR.",
            "suffix": "JR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.