Individual provider Active NPI

Jane Ann Clemen, RD/LD

  • Registered Dietitian
  • Elkader, IA
National Provider Identifier
1902993942
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
305 00097 Issued in IA
Practice address
901 Davidson St NW
Elkader, IA 52043-9015
Phone
(563) 245-7000
Fax
(563) 245-7080
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 305 00097 IA Primary

Addresses

Primary practice location

901 Davidson St NW
Elkader, IA 52043-9015

Mailing address

22750 Wulfekuhle Rd
Holy Cross, IA 52053-9719
Phone (563) 245-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
305 00097IAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902993942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22750 WULFEKUHLE RD",
            "city": "HOLY CROSS",
            "state": "IA",
            "postal_code": "520539719",
            "telephone_number": "563-245-7000",
            "fax_number": "563-245-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DAVIDSON ST NW",
            "city": "ELKADER",
            "state": "IA",
            "postal_code": "520439015",
            "telephone_number": "563-245-7000",
            "fax_number": "563-245-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMEN",
        "first_name": "JANE",
        "middle_name": "ANN",
        "credential": "RD/LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "305 00097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkader, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.