JOHN CLEMMONS PHD
NPI 1104916766
Psychologist in Hattiesburg, MS
About John Clemmons Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN CLEMMONS PHD (NPI 1104916766) is an individual psychologist in Hattiesburg, Mississippi, licensed in Mississippi (52911) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2004).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
John Clemmons Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show John Clemmons reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hattiesburg, MS 39402
- Reassigned Medicare billing, Mississippi enrollment
- 86 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HATTIESBURG, MS 39402
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 John Clemmons's NPI number?
The NPI number for John Clemmons is 1104916766. It was assigned to this individual provider in the NPPES registry on October 13, 2006.
Where is John Clemmons located?
John Clemmons practices at 239 Methodist Blvd, Hattiesburg, MS 39402. The listed phone number is (601) 296-2125.
What is John Clemmons's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is John Clemmons enrolled in Medicare?
Yes. John Clemmons is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for John Clemmons's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Clemmons reassigns Medicare benefits to Wesley Physician Services LLC (Hattiesburg, 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 John Clemmons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Clemmons accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list John Clemmons 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 John Clemmons was last updated on October 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# John Clemmons, PHD · NPI 1104916766
Psychologist provider in Hattiesburg, Mississippi. Individual provider, active in the CMS NPPES registry since October 13, 2006.
## Identity
- **NPI:** 1104916766 (Entity type: Individual)
- **Enumerated:** October 13, 2006
- **Primary specialty:** Psychologist · taxonomy 103T00000X
- **State license:** 52911 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 239 METHODIST BLVD, Hattiesburg, MS 39402-1297
- **Phone:** (601) 296-2125 · **Fax:** (601) 268-8645
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Wesley Physician Services LLC (NPI 1538200209, Hattiesburg, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2004
## Record status
- **NPPES last updated:** October 8, 2020
- **Other identifiers:** Medicaid 03051508 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1104916766) · Data from the CMS NPPES public registry.