CLEMSON UNIVERSITY
NPI 1093990707
Nurse Practitioner - Family in Walhalla, SC
About Clemson University NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLEMSON UNIVERSITY (NPI 1093990707) is a healthcare organization registered as a family in Walhalla, South Carolina and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2028, maintains 2 additional practice locations, and lists Ronald W Gimbel, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Secondary Practice Locations 2
Other Identifiers 1
Group Practice 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clemson University is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
17Medicare enrollment records show 17 clinicians reassign Medicare billing to Clemson University, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 6
Clinicians, nearest first (17)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 42D0696372
Clemson University Fire Dept · Clemson, SCFrequently 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 Clemson University's NPI number?
The NPI number for Clemson University is 1093990707. It was assigned to this organization in the NPPES registry on January 2, 2008. The provider is also known as Clemson University Clemson Rural Health.
Where is Clemson University located?
Clemson University is located at 200 Booker Dr, Walhalla, SC 29691. The listed phone number is (864) 656-1969.
What is Clemson University's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Clemson University enrolled in Medicare?
Yes. Clemson University is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Clemson University?
According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 6 Medicare specialties reassign their Medicare billing to Clemson University. A 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 the clinician's services. The largest specialties are Nurse Practitioner (11), Registered Dietitian or Nutrition Professional (2) and Clinical Social Worker (1). Of these, 7 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Clemson University hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D0696372) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Clemson University accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and First Choice Next list Clemson University 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 Clemson University was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Clemson University · NPI 1093990707
Family organization in Walhalla, South Carolina. Organization record, active in the CMS NPPES registry since January 2, 2008.
## Identity
- **NPI:** 1093990707 (Entity type: Organization)
- **Enumerated:** January 2, 2008
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** Clemson University Clemson Rural Health (Other Name)
- **Organization subpart:** No
- **Authorized official:** Ronald Gimbel, DIRECTOR
## Practice location
- **Address:** 200 BOOKER DR, Walhalla, SC 29691-2278
- **Phone:** (864) 656-1969 · **Fax:** (843) 985-9562
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 17 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (11), Registered Dietitian or Nutrition Professional (2), Clinical Social Worker (1); 7 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 15, 2025
- **Other identifiers:** Medicaid GP1885 (SC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093990707) · Data from the CMS NPPES public registry.