Barry S Clemson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036086030 Issued in IL

Practice address

5405 N Knoxville Ave
Peoria, IL 61614-5016

Phone

(309) 691-4410

Fax

(309) 692-4730

NPI assigned

Jul 10, 2006

Last updated

Jan 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• St Joseph Medical Center

  dba OSFMG - Bloomington

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1942234323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410",
            "fax_number": "309-692-4730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410",
            "fax_number": "309-692-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMSON",
        "first_name": "BARRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086030",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036086030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086030",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Claypool, MD
• Ninah Clegg-Johnson, DO
• Ruchira Clementina
• Gregory Clementz
• Jacqueline Lee Clemons, LCSW
• Briana Cline, OTR/L
• Robert A. Cline, PTA
• Jean L Clore, PHD
• Bradley Cobb
• Johni Lynn Cochran, NNP-BC

• Cardiovascular Disease Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.