JERRICA CLEMENS (NPI# 1467067975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467067975 |
| Entity Type | Individual |
| Full Name | JERRICA CLEMENS |
| Credential | PA-C |
| Practice Address |
4100 Woodward Ave Detroit MI 48201-2173 |
| Mailing Address |
29900 Meridian Pl Apt 22102 Farmington Hills MI 48331-5805 |
| Practice Telephone | 2482259855 |
| Practice Fax Number | 2487922128 |
| Mailing Telephone | 8106144595 |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2020-10-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601010168 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4100 WOODWARD AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407223803 | Midtown Rx Pharmacy Inc | Pharmacy | 4100 Woodward Ave, Suite Pharmacy, Detroit, MI 48201-2173 | 2015-09-01 |
| 1609229848 | Detroit Medical Consultants PC | Internal Medicine | 4100 Woodward Ave, Detroit, MI 48201-2173 | 2016-07-22 |
| 1366892135 | Suraya Wail Hammoudeh | Pharmacist | 4100 Woodward Ave, Detroit, MI 48201-2173 | 2016-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831340355 | Antonia L Navarro | Physician Assistant | University Physician Group Oncology, 4100 John R, Detroit, MI 48201-2013 | 2008-10-02 |
| 1104974443 | Amy B Oatfield | Physician Assistant | Henry Ford Hospital Trauma and Critical Care Cfp-1, 2799 West Grand Blvd, Detroit, MI 48202 | 2007-01-05 |
| 1295750677 | Ingrid Dominic Mitchell | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221-4214 | 2006-07-13 |
| 1952397291 | Kelly Michelle Brown | Physician Assistant | 22151 Moross Rd Ste 320, Maternal Fetal Medicine St John Hospital & Medical Cen, Detroit, MI 48236-2196 | 2005-09-22 |
| 1679195176 | Shane Michael Dignan | Physician Assistant | 259 Mack Ave, Detroit, MI 48201-2427 | 2020-05-07 |
| 1174154843 | Weston Alexander Davis | Physician Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-01-30 |
| 1689225443 | Alaa Eddin Tahboub | Physician Assistant | 4771 Michigan Ave, Detroit, MI 48210-9718 | 2019-09-24 |
| 1609338367 | Aanchal Bhojwani | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2019-04-02 |
| 1952883068 | Jeremy Lynn Herzberg | Physician Assistant | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-09-05 |
| 1124508122 | Chadius M Milton | Physician Assistant | 18254 Livernois Ave Ste 1, Detroit, MI 48221 | 2018-08-19 |
| Find all providers in DETROIT | ||||
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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.