ELISE REBECCA CLEM (NPI# 1386038214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386038214 |
| Entity Type | Individual |
| Full Name | ELISE REBECCA CLEM |
| Practice Address |
1874 Beltline Rd Sw Ste 105 Decatur AL 35601-5514 |
| Practice Telephone | 2563559711 |
| Practice Fax Number | 2563519717 |
| Mailing Telephone | 2563559711 |
| Mailing Fax Number | 2563519717 |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD35791 | AL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1700 Center St Cweb 100, Mobile, AL 366880001 | 2514158602 | 2514151552 |
| Street Address |
1874 BELTLINE RD SW STE 105 |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-5514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649742560 | Bethel Renfrow | Obstetrics & Gynecology | 1874 Beltline Rd Sw Ste 105, Decatur, AL 35601-5514 | 2018-12-18 |
| 1760848972 | Shequita Madry Bridgeforth | Obstetrics & Gynecology | 1874 Beltline Rd Sw Ste 105, Decatur, AL 35601-5514 | 2016-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1336408830 | Mishanta Reyes | Obstetrics & Gynecology | 1215 7th St Se Fl 2, Decatur, AL 35601 | 2012-05-04 |
| 1295027753 | Georgia Center for Female Health LLC | Obstetrics & Gynecology | 3660 Flat Shoals Pkwy Ste 180, Decatur, GA 30034-1632 | 2011-05-03 |
| 1316258056 | Sarah E. Winter | Obstetrics & Gynecology | 544 W Pershing Rd Ste 200, Decatur, IL 62526 | 2010-06-28 |
| 1790916591 | Philip C Lynch | Obstetrics & Gynecology | 867 W Harper Ave, Decatur, IL 62526-3918 | 2009-07-28 |
| 1972744084 | Decatur General Hospital | Obstetrics & Gynecology | 1107 14th Avenue Se, Suite 320, Decatur, AL 35601 | 2009-03-19 |
| 1255583324 | Decatur General Hospital | Obstetrics & Gynecology | 1202 13th Aveneue Se, Decatur, AL 35601 | 2008-10-21 |
| 1851559983 | Amy Marie Rodatus | Obstetrics & Gynecology | 2801 N Decatur Rd Ste 190, Decatur, GA 30033-5924 | 2008-05-27 |
| 1811191620 | Jacquelyn Amber Stone | Obstetrics & Gynecology | 1304 13th Ave, S.e., Suite B, Decatur, AL 35601-4316 | 2007-06-14 |
| Find all providers in DECATUR | ||||
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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.