JEFFREY D CLEMENT (NPI# 1164420576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164420576 |
| Entity Type | Individual |
| Full Name | JEFFREY D CLEMENT |
| Credential | MD |
| Practice Address |
1076 N Main St Providence RI 02904-5760 |
| Practice Telephone | 4018617711 |
| Practice Fax Number | 4014215710 |
| Mailing Telephone | 4018617711 |
| Mailing Fax Number | 4014215710 |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2015-12-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | RI09696 | RI | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
RI09696 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 7006284 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811191455 | Jeffrey Payne Clement | Physical Therapist | 1915 Randolph Rd, Charlotte, NC 28207-1101 | 2007-06-14 |
| Street Address |
1076 N MAIN ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-5760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295733988 | Richard A Cottiero | Internal Medicine | 1076 N Main St, Ste 3, Providence, RI 02904 | 2005-07-07 |
| 1144616715 | Edward Medeiros | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2015-04-10 |
| 1700131125 | Josef Edrik Keith Abiog Bautista | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2012-07-23 |
| 1912177734 | Patricia Ann Petrillo | Dietitian, Registered | 1076 N Main St, Providence, RI 02904-5760 | 2008-03-07 |
| 1073799573 | Arnoldas Giedrimas | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2008-01-14 |
| 1568667434 | Keith R Bartolomei | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2007-06-19 |
| 1669598868 | Melissa Jane Savicki | Physician Assistant | 1076 N Main St, Providence, RI 02904-5760 | 2007-03-21 |
| 1639277072 | Hypertension & Nephrology, Inc. | Specialist | 1076 N Main St, Providence, RI 02904-5760 | 2006-09-20 |
| 1487607693 | Louis R Maiello | Radiology | 1076 N Main St, Providence, RI 02904-5760 | 2006-05-18 |
| 1326091711 | Cranston Mri PC | Radiology | 1076 N Main St, Providence, RI 02904-5760 | 2006-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477087070 | Muhammad Waqar Liaqat | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2017-04-20 |
| 1144616715 | Edward Medeiros | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2015-04-10 |
| 1700131125 | Josef Edrik Keith Abiog Bautista | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2012-07-23 |
| 1306123476 | Providence Interventional Associates II LLC | Internal Medicine | 100 Highland Ave, Providence, RI 02906-2740 | 2011-11-03 |
| 1457509556 | Marc Weinberg Md Personal Healthcare Ltd | Internal Medicine | 1 Randall Sq Ste 304, Providence, RI 02904-2773 | 2008-09-03 |
| 1568667434 | Keith R Bartolomei | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2007-06-19 |
| 1437223658 | Ayman M. Wahbeh | Internal Medicine | 593 Eddy St, Middle House 3, Providence, RI 02903-4923 | 2006-11-20 |
| 1639108384 | Andrew J. Cohen | Internal Medicine | 593 Eddy St, Apc 9, Providence, RI 02903-4923 | 2006-07-02 |
| 1346249695 | David C Yoburn | Internal Medicine | 1076 N Main St, Providence, RI 02904-5760 | 2005-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356738819 | Robert M Serra, Md | Internal Medicine | 19 Canyon Dr, Westerly, RI 02891-3814 | 2015-04-22 |
| 1790975191 | Maroun E Azar | Internal Medicine | 250 Centerville Rd Bldg E, Warwick, RI 02886 | 2007-07-31 |
| 1770998338 | Manini Vishwanath | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914 | 2014-06-23 |
| 1518109073 | Peter C Shorter | Internal Medicine | 70 Kenyon Ave, Suite 104, Wakefield, RI 02879-4239 | 2009-03-30 |
| 1982892824 | George P Bayliss | Internal Medicine | 375 Wampanoag Trl, Suite 302a, Riverside, RI 02915-2232 | 2007-10-04 |
| 1124225594 | Mordecai Jeremiah Stolk | Internal Medicine | 318 Waterman Ave, East Providence, RI 02914-3525 | 2007-06-29 |
| 1770665424 | Shoreline Nephrology Associates, Inc. | Internal Medicine | 17 Wells St, Suite 202, Westerly, RI 02891-2923 | 2006-10-20 |
| 1740394030 | Robert Michael Serra | Internal Medicine | 17 Wells St, Westerly, RI 02891-2923 | 2006-08-17 |
| 1609889419 | Joseph Michael Romanello | Internal Medicine | 17 Wells St, Suite 202, Westerly, RI 02891-2923 | 2006-08-14 |
| 1477579407 | Mark J Mancini | Internal Medicine | 17 Wells St, Suite 202, Westerly, RI 02891-2923 | 2006-07-14 |
| Find all providers with the same taxonomy | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.