NPIMap

Individual provider Active NPI

John B Clendenin, M.D.

  • Family Medicine Physician
  • Union City, TN
National Provider Identifier
1265412563
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25947 Issued in TN
Practice address
1412 E Reelfoot Ave
Union City, TN 38261-5813
Phone
(731) 885-5131
Fax
(731) 885-5335
NPI assigned
Jan 20, 2006
Last updated
Oct 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25947 TN Primary

Addresses

Primary practice location

1412 E Reelfoot Ave
Union City, TN 38261-5813

Mailing address

PO Box 405827
Atlanta, GA 30384-5827

Other identifiers 2

IdentifierTypeStateIssuer
080090136OtherTNRAILROAD MEDICARE
3084699MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610001115 TN Practitioner - Family Practice 1951431345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1412 E Reelfoot Ave
Union City, TN 38261-5813
Phone (731) 885-5131

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25947TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Family Medicine CurrentSince Feb 1, 2012 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Feb 1, 2012 Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

7205 Wolf River Blvd
Ste 100
Memphis, TN 38138
Phone (901) 507-9466

8970 Winchester Rd
Memphis, TN 38125
Phone (901) 794-5806

1020 E Reelfoot Ave
Union City, TN 38261
Phone (731) 885-5131

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

1412 E Reelfoot Ave
Union City, TN 38261
Phone (731) 885-5131

Interoperability endpoints

  • Direct secure messaging: jclendenin4596@direct.bmhcc.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1265412563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 E REELFOOT AVE",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615813",
            "telephone_number": "731-885-5131",
            "fax_number": "731-885-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLENDENIN",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "25947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080090136",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3084699",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.