Individual provider Active NPI

Rebecca Dawn Clem, MSN, APRN, FNP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1285855981
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12713 Issued in TN
Practice address
1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone
(865) 584-2146
Fax
(865) 584-9660
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12713 TN Primary

Addresses

Primary practice location

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291

Mailing address

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146

Other identifiers 1

IdentifierTypeStateIssuer
1507356MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clem.rebecca@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080228000080 TN Practitioner - Nurse Practitioner 1153405246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146

1320 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-1054

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12713TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Jan 1, 2013 Accepting new patients
Abercrombie Radiological Consultants Inc Past Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients
Familycare Specialists PC Past Accepting new patients

Locations

1320 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-1054

Dept 888179
Knoxville, TN 37995

1300 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-2146

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: clem.rebecca@covenanthealth.cernerdirect.com

Organizations & group practices 5

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

Hospital & facility affiliations 2

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1285855981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEM",
        "first_name": "REBECCA",
        "middle_name": "DAWN",
        "credential": "MSN, APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507356",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clem.rebecca@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1300 Old Weisgarber Rd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379091291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.