Jinnyi Clements, AGCNS-BC

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

3009770 Issued in KY

Practice address

851 Kimsey LN
Henderson, KY 42420-2665

Phone

(731) 394-1145

NPI assigned

Dec 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Pineville Community Health Center IncGroup PAC ID 5698009157, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
• Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

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 and National Provider Directory roles.

• Ultra Health LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1922469543

  KY

  Medicare reassignment Care Compare group
• Icats Management Integrated Care and Transition Services LLC

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1033559240
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Health, Inc.

  • General Acute Care Hospital
  • Henderson, KY
  • NPI 1083759633
  Care Compare affiliation
• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427
  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642
  Care Compare affiliation

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1942608328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PEMBERTON CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055514",
            "telephone_number": "731-394-1145",
            "fax_number": "844-374-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 KIMSEY LN",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202665",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 State St",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471504916",
            "country_code": "US",
            "telephone_number": "502-327-9100",
            "fax_number": "855-632-8329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Bentee Wes Ct",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477154071",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "JINNYI",
        "credential": "AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71013259A",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KY",
            "license": "3009770",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "3009770",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13616310",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maliyah Devon Chinn
• Muthamilan Chinnairusan, M.D.
• Christina Gail Hanor Mitchell
• Drue Clark, PHARMD
• Leslie Mason Clark, R.D., L.D.
• Andrea Lynn Clemons
• Paula Renae Collins, OTR, ATP
• Committed Transportation Services
• Community Alternatives Kentucky, Inc.
• Community United Methodist Hospital, Inc.

• Adult Health Clinical Nurse Specialist in Henderson, KY
• Providers in Henderson, KY by specialty
• Adult Health Clinical Nurse Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.