Individual provider Active NPI

Ronda Lee Clements, APN

  • Obstetrics & Gynecology Nurse Practitioner
  • Walnut Ridge, AR
National Provider Identifier
1891747531
Registry record updated Sep 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
A01031 Issued in AR
Practice address
1050 W Free St
Walnut Ridge, AR 72476-1752
Phone
(870) 886-3201
Fax
(870) 886-1722
NPI assigned
May 17, 2006
Last updated
Sep 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X A01031 AR Primary

Addresses

Primary practice location

1050 W Free St
Walnut Ridge, AR 72476-1752

Mailing address

1068 Third Ave
Walnut Ridge, AR 72476-8433
Phone (870) 886-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20141218002217 AR Practitioner - Nurse Practitioner 8921223249

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A01031ARMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1891747531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 THIRD AVE",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724768433",
            "telephone_number": "870-886-5553",
            "fax_number": "870-886-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W FREE ST",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761752",
            "telephone_number": "870-886-3201",
            "fax_number": "870-886-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "RONDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AR",
            "license": "A01031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Ridge, AR

Sources for this page

Verify at the official NPI Registry.