Individual provider Active NPI

Elizabeth L Clemons, MD

  • Dermatology Physician
  • Bossier City, LA
National Provider Identifier
1881854883
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD.204911 Issued in LA
Practice address
2300 Hospital Dr
Ste 400
Bossier City, LA 71111-2180
Phone
(318) 222-3278
NPI assigned
Jun 12, 2008
Last updated
Jun 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A119801 CA
Dermatology Physician 207N00000X MD.204911 LA Primary

Addresses

Primary practice location

2300 Hospital Dr
Ste 400
Bossier City, LA 71111-2180

Mailing address

2300 Hospital Dr
Ste 400
Bossier City, LA 71111-2180
Phone (318) 222-3278

Other practice location 1

9007 Ellerbe Rd
Shreveport, LA 71106-6724
Phone (318) 222-3278

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141121001811 LA Practitioner - Dermatology 8022260215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Dermatology ClinicGroup PAC ID 5092814434, 4 clinicians

Practice addresses (Care Compare)

2300 Hospital Dr
Suite 400
Bossier City, LA 71111-2180
Phone (318) 212-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.53 of 100Reported as apm
Quality
81.42
Promoting interoperability
94.6
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision114
Removal of skin lesions1748
Removal or shaving of skin growth1-10
Skin biopsy350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Skin Surgery Apmc Dermatology CurrentSince Dec 15, 2014 Accepting new patients
WK Dermatology Clinic Dermatology CurrentSince Oct 1, 2017 Accepting new patients

Locations

2300 Hospital Dr
Ste 400
Bossier City, LA 71111
Phone (318) 212-7800

1811 E Bert Kouns Industrial Loop
#110
Shreveport, LA 71105
Phone (318) 212-3440

1811 E Bert Kouns Industrial Loop
Ste 160
Shreveport, LA 71105
Phone (318) 212-3223

7941 Youree Dr
Shreveport, LA 71105
Phone (318) 797-7941

9007 Ellerbe Rd
Shreveport, LA 71106
Phone (318) 222-3278

Interoperability endpoints

  • Direct secure messaging: eclemons@direct.wkhs.com

Organizations & group practices 2

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 4

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1881854883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "STE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112180",
            "telephone_number": "318-222-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "STE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112180",
            "telephone_number": "318-222-3278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9007 Ellerbe Rd",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711066724",
            "country_code": "US",
            "telephone_number": "318-222-3278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A119801",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.204911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.