Active NPI
John F. Robertson III, MD
- Surgery Physician
- Johnson City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD36238
- Practice address
- 2 Professional Park Dr Ste 11
Johnson City, TN 37604-6584 - Phone
- (423) 975-5650
- Fax
- (423) 975-5652
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD36238 | TN | Primary |
Addresses
Primary practice location
2 Professional Park Dr Ste 11
Johnson City, TN 37604-6584
Mailing address
PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30016502830002 | Medicaid | VA | |
| Q013108 | Medicaid | TN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- University of Louisville School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
9430 Parkwest Blvd
Suite 310
Knoxville, TN 37923-4203
Phone (865) 690-5263
Hospital & facility affiliations
- Franklin Woods Community Hospital
- Johnson City Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 17 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 13 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD36238 | TN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Surgical Associates, PLLC | Surgery | Current | Accepting new patients |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients | |
| Premier Surgical Associates, PLLC | Surgery | Current | Accepting new patients |
| Mountain States Health Alliance | Past | Accepting new patients |
Locations
1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380
101 Med Tech Pkwy
Ste 405
Johnson City, TN 37604
Phone (423) 929-2452
1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000
2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867
3 Professional Park Dr
Ste 31
Johnson City, TN 37604
Phone (423) 232-6900
2 Professional Park Dr
Ste 11
Johnson City, TN 37604
Phone (423) 434-0642
9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045
Organizations & group practices 6
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.
-
- Surgery Physician
- Knoxville, TN
- NPI 1750449443
-
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
-
- Neurological Surgery Physician
- Johnson City, TN
- NPI 1003152307
-
- Family Medicine Physician
- Johnson City, TN
- NPI 1982553756
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1114033628
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1114033628
-
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1851387872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52948",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379502948",
"telephone_number": "865-306-5700",
"fax_number": "865-584-7760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 PROFESSIONAL PARK DR STE 11",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046584",
"telephone_number": "423-975-5650",
"fax_number": "423-975-5652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "JOHN",
"middle_name": "F.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "MD36238",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30016502830002",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q013108",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.