Nicholas Benjamin Clemmons

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN227788 Issued in GA

Practice address

818 Tabby LN
Athens, GA 30605-7058

Phone

(229) 449-4524

NPI assigned

Oct 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland Emergency Medical Services Consolidated, LLCGroup PAC ID 4183871320, 48 clinicians

Hospital Authority of Wilkes CountyGroup PAC ID 8628051489, 8 clinicians

Wills Memorial Emergency Medical Services, LLCGroup PAC ID 9335419563, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wills Memorial Hospital Hospital, Washington, GA, CCN 111325

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.

• Hospital Authority of Wilkes County

  • Rural Health Clinic/Center
  • Lincolnton, GA
  • NPI 1801128863
  Medicare reassignment Care Compare group NPD
• Southland Emergency Medical Services Consolidated, LLC

  • Hospitalist Physician
  • Cochran, GA
  • NPI 1033464391
  Medicare reassignment Care Compare group
• Wills Memorial Emergency Medical Services, LLC

  • Emergency Medicine Physician
  • Washington, GA
  • NPI 1275066326
  Medicare reassignment Care Compare group
• Southland Consolidated Emergency Services, LLC

  • Emergency Medicine Physician
  • Elberton, GA
  • NPI 1174917124
  Medicare reassignment
• Hospital Authority of Wilkes County

  • Critical Access Hospital
  • Washington, GA
  • NPI 1477759462
  NPD
• Hospital Authority of Wilkes County

  • Rural Health Clinic/Center
  • Washington, GA
  • NPI 1023332970
  NPD (past)

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

• Hospital Authority of Wilkes County

  • Critical Access Hospital
  • Washington, GA
  • NPI 1619961695
  Care Compare affiliation

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1881357127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 TABBY LN",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306057058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 TABBY LN",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306057058",
            "telephone_number": "229-449-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "NICHOLAS",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN227788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Classic City Orthodontics
• Classic City Rehab LLC
• Classic City Surgical Assistants LLC
• Rachel Corinne Clay, D.D.S.
• George Cleland, MD
• Sarah Clemmons
• Janna Barham Cleveland, FNP-BC
• Ruth M Cline, M.D.
• Lanina Cobb-Thompson, LAPC
• Carl Nolan Cobb Jr., CRNA

• Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.

Verify at the official NPI Registry.