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DR. DEREK ALAN CLEMMER D.M.D.
NPI 1023322765
Dentist in Ashland, MS

Active since August 05, 2010PECOS Enrolled
15921 BOUNDARY DR, ASHLAND, MS 38603(662) 224-8951 Get Directions Write a Review

NPPES record last updated: August 5, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Derek Alan Clemmer D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DEREK ALAN CLEMMER D.M.D. (NPI 1023322765) is an individual dentist in Ashland, Mississippi, licensed in Mississippi (3565-10) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS and is a graduate of Other.

NPPES Registry Identity

NPI1023322765
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. DEREK ALAN CLEMMERCredential: D.M.D.
Location Address15921 BOUNDARY DRAshland, MS 38603-7740
Mailing AddressPo Box 92Ashland, MS 38603-0092 · (662) 224-8951 · Fax (662) 224-6801
Phone(662) 224-8951
Sole ProprietorNo
Medical School CMSOther
Enumeration DateAugust 5, 2010
✔ NPI 1023322765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MS · 3565-10
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
15921 BOUNDARY DR, Ashland, MS 38603
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Derek Alan Clemmer D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658840665
PECOS Enrollment IDI20260519004492
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Derek Clemmer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Boa Vida Hospital Of Aberdeen, Ms, LLC
79 mi
Multi-Specialty
400 S CHESTNUT ST
Aberdeen, MS 39730
  • Reassigned Medicare billing, Mississippi enrollment
  • Also billed through NPI 1285164046 (Mississippi)
  • 168 clinicians in this Medicare group
NPI 1710405741 (219) 395-0667

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38603 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Bus
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 502-3137
CHRISTY WILLIAMS LCSW
Social Worker (Clinical)
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951
MRS. JOYCE L SMITH F.N.P
Nurse Practitioner (Family)
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 223-4011
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Dentist (General Practice)
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951
BRANDON WESLEY HUTCHISON FNP
Nurse Practitioner (Family)
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951
HANNAH POFF WILSON FNP
Nurse Practitioner
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951
ANKIT BAVARIYA MDS
Dentist (Periodontics)
15921 BOUNDARY DR
ASHLAND, MS 38603
Benton County (662) 224-8951

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Clemmer's NPI number?

The NPI number for Derek Clemmer is 1023322765. It was assigned to this individual provider in the NPPES registry on August 5, 2010.

Where is Derek Clemmer located?

Derek Clemmer practices at 15921 Boundary Dr, Ashland, MS 38603. The listed phone number is (662) 224-8951.

What is Derek Clemmer's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Derek Clemmer enrolled in Medicare?

Yes. Derek Clemmer is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Derek Clemmer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Derek Clemmer reassigns Medicare benefits to Boa Vida Hospital Of Aberdeen, Ms, LLC (Aberdeen, MS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Derek Clemmer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Derek Clemmer accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 9 other insurers list Derek Clemmer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derek Clemmer was last updated on August 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.