TARA N CLEMENS (NPI# 1164455689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164455689 |
| Entity Type | Individual |
| Full Name | TARA N CLEMENS |
| Credential | PA |
| Practice Address |
5995 Iris Parkway Box 189 Frederick CO 80530 |
| Mailing Address |
203 S Rollie Ave Fort Lupton CO 80621-1508 |
| Practice Telephone | 3038332050 |
| Practice Fax Number | 3038339183 |
| Mailing Telephone | 3032864560 |
| Mailing Fax Number | 3032864589 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2013-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.0002098 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 85584541 | 05 |
| Street Address |
5995 IRIS PARKWAY BOX 189 |
| City | FREDERICK |
| State | CO |
| Zip Code | 80530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295708733 | Allison L Gorab | Dentist | 5995 Iris Parkway, Frederick, CO 80530 | 2006-02-07 |
| 1356686083 | Alison Marie Godinez | Physician Assistant | 5995 Iris Parkway, Frederick, CO 80530-4849 | 2012-12-06 |
| 1508173121 | Rosario I Almiron | Dentist | 5995 Iris Parkway, Frederick, CO 80530-4849 | 2010-09-02 |
| 1699910240 | Andrea Maria Auxier | Psychologist | 5995 Iris Parkway, Salud Family Health Centers, Frederick, CO 80530 | 2008-12-11 |
| 1487851473 | Ethan E Kerns | Dentist | 5995 Iris Parkway, Frederick, CO 80530 | 2007-07-02 |
| 1699980144 | Debby S Myers | Dental Hygienist | 5995 Iris Parkway, Frederick, CO 80530 | 2007-05-10 |
| 1376557959 | Melanie Suzanne Metcalf | Family Medicine | 5995 Iris Parkway, Frederick, CO 80530 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144367210 | Kersten Chiropractic PC | Chiropractor | 630 Main St., A, Frederick, CO 80530 | 2007-01-30 |
| 1710036306 | Heeling Hands, LLC | Massage Therapist | 142 6th St., Frederick, CO 80530 | 2007-01-10 |
| 1265580914 | Mark Jerel Ringdahl | Dentist | 320 5th St., Po#69, Frederick, CO 80530 | 2007-01-08 |
| 1255400107 | Frederick Area Fire Protection District | Ambulance | 31 Walnut Drive, Frederick, CO 80530 | 2006-11-07 |
| 1982611679 | Jilba Meryl Wallace | Counselor | 541 Oak Street, Ste 2, Frederick, CO 80530 | 2006-08-02 |
| 1619218856 | Carbon Valley Chiropractic | Chiropractor | 630 Main Street, Suite A, Frederick, CO 80530 | 2013-03-13 |
| 1558665273 | Carolyn Deolinda Bullock | Dentist | 320 5th St, Frederick, CO 80530 | 2011-01-10 |
| 1952549636 | The Lions Tooth, LLC | Clinic/Center | 630 Main Street, Unit B, Frederick, CO 80530 | 2009-02-03 |
| 1366692485 | Kersten Health, P.C. | Chiropractor | 630 Main St., Suite A, Frederick, CO 80530-0126 | 2008-09-25 |
| 1669809380 | New Hope Behavioral Center LLC | Counselor | 142 6th St #3, Frederick, CO 80530-0520 | 2013-09-27 |
| Find all providers in zip 80530 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801164066 | Atekelt Yilma Tadese | Physician Assistant | 46-b Thomas Johnson Drive, Suite 200, Frederick, MD 21702 | 2011-12-02 |
| 1619121472 | Barbara S. Rebele | Physician Assistant | 22 S Market St, Suite 6d, Frederick, MD 21701-5570 | 2008-11-06 |
| 1790954253 | Robert Paul Cathor | Physician Assistant | 56 Thomas Johnson Drive, Ste 110, Frederick, MD 21702-4599 | 2008-02-28 |
| 1598946006 | Justina A Bennett | Physician Assistant | 85 Thomas Johnson Ct, Suite C, Internal Medicine Specialists of Frederick, Frederick, MD 21702 | 2007-11-27 |
| 1104809342 | Tara Carson Jernejcic | Physician Assistant | 100 South Market Street, Frederick Community Action Agency, Frederick, MD 21701 | 2005-11-22 |
| 1376001214 | Lewis Edel Bertus | Physician Assistant | 610 Solarex Ct, Frederick, MD 21703-8624 | 2019-03-11 |
| 1922510056 | Paola Haros | Physician Assistant | 196 Thomas Johnson Dr, Frederick, MD 21702-4397 | 2017-10-30 |
| 1861867459 | Kelly Murray | Physician Assistant | 915 Toll House Ave Ste 103, Frederick, MD 21701-5911 | 2015-12-08 |
| 1295142388 | Rebecca Alyson Leonard | Physician Assistant | 63 Thomas Johnson Dr, Suite E, Frederick, MD 21702-4384 | 2014-07-21 |
| 1912332123 | Brittany Leigh Henry | Physician Assistant | 87 Thomas Johnson Dr Ste 101, Frederick, MD 21702-4427 | 2013-09-06 |
| Find all providers in FREDERICK | ||||
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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.