Individual provider Active NPI

John D Huber III, MD

  • Dermatopathology Physician
  • Memphis, TN
National Provider Identifier
1760459069
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
MD35071 Issued in TN
Practice address
1455 Union Avenue
Memphis, TN 38104-6727
Phone
(901) 726-6655
Fax
(901) 726-9056
NPI assigned
Mar 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X MD35071 TN
Dermatopathology Physician 207ND0900X MD35071 TN Primary
Procedural Dermatology Physician 207NS0135X MD35071 TN

Addresses

Primary practice location

1455 Union Avenue
Memphis, TN 38104-6727

Mailing address

1455 Union Avenue
Memphis, TN 38104-6727
Phone (901) 726-6655

Other identifiers 1

IdentifierTypeStateIssuer
3864281MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001156 TN Practitioner - Dermatology 4183749674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Tennessee, HSC, College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Dermatology, PCGroup PAC ID 2163474297, 9 clinicians

Practice addresses (Care Compare)

6644 Summer Knoll Cir
Bartlett, TN 38134-2875
Phone (901) 372-4545

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision159
Removal of skin lesions564
Removal of skin cancer272
Removal or shaving of skin growth1-10
Skin biopsy405

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD35071TNMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Dermatology Clinic PA Mohs-Micrographic Surgery CurrentSince Jul 1, 1999 Accepting new patients
Mid-South Dermatology, PC CurrentSince Jan 3, 2022 Accepting new patients
Dr. Adam T Keres LLC. PastSince Aug 12, 2017 Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

6644 Summer Knoll Cir
Bartlett, TN 38134
Phone (901) 372-4545

1455 Union Ave
Memphis, TN 38104
Phone (901) 726-6655

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1760459069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 UNION AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 UNION AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "MD35071",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TN",
            "license": "MD35071",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "MD35071",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3864281",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.