Active NPI
Jeffrey Clemens, M.D.
- Family Medicine Physician
- Miramar, FL
National Provider Identifier
1912984865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- DR.0032991
- Practice address
- 3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308 - Phone
- (877) 866-7123
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 32991 | CO | |
| Family Medicine Physician | 207Q00000X | DR.0032991 | CO | Primary |
Addresses
Primary practice location
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Mailing address
2920 Phoenix PT
Colorado Springs, CO 80906-6731
Phone (719) 351-9587
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01329911 | Medicaid | CO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32991 | CO | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1912984865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 PHOENIX PT",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809066731",
"telephone_number": "719-351-9587",
"fax_number": "719-477-1106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 SW 160TH AVE",
"address_2": "SUITE 250",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330276308",
"telephone_number": "877-866-7123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENS",
"first_name": "JEFFREY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-30",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "32991",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "DR.0032991",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01329911",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.