Individual provider Active NPI

Thurgood Clemon-King

  • Case Management Registered Nurse
  • Pontiac, MI
National Provider Identifier
1992655260
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
4704392331 Issued in MI
Practice address
44200 Woodward Ave Ste 212
Pontiac, MI 48341-5045
Phone
(248) 332-4540
NPI assigned
Jan 28, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704392331 MI
Ambulatory Care Registered Nurse 163WP2201X 4704392331 MI
Case Management Registered Nurse 163WC0400X 4704392331 MI Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 4704392331 MI
Registered Nurse 163W00000X 4704392331 MI

Addresses

Primary practice location

44200 Woodward Ave Ste 212
Pontiac, MI 48341-5045

Mailing address

44200 Woodward Ave Ste 212
Pontiac, MI 48341-5045

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
4704392331MIMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1992655260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE STE 212",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE STE 212",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-332-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMON-KING",
        "first_name": "THURGOOD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704392331",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MI",
            "license": "4704392331",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MI",
            "license": "4704392331",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "4704392331",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704392331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.