Individual provider Active NPI

Robert John Clemons, M.D.

  • Procedural Dermatology Physician
  • Johnson City, TN
National Provider Identifier
1861495012
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
35668 Issued in TN
Practice address
1009 North State of Franklin Access Road
Johnson City, TN 37604
Phone
(423) 929-7546
Fax
(423) 929-7968
NPI assigned
May 23, 2005
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
Dermatology Physician 207N00000X 35668 TN
Pediatric Dermatology Physician 207NP0225X 35668 TN
Procedural Dermatology Physician 207NS0135X 35668 TN Primary

Addresses

Primary practice location

1009 North State of Franklin Access Road
Johnson City, TN 37604

Mailing address

1009 North State of Franklin Access Road
Johnson City, TN 37604
Phone (423) 929-7546

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
I20111207000142 TN Practitioner - Dermatology 6800817917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tricities Skin and Cancer.Group PAC ID 8527031954, 15 clinicians

Practice addresses (Care Compare)

1009 N State of Franklin Rd
Johnson City, TN 37604-3693
Phone (423) 929-7546

Merit-based Incentive Payment System (MIPS)

Final score
85.14 of 100Reported as group
Quality
76.93
Improvement activities
40
Cost
81.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions2413
Removal of nail tissue1-10
Removal or shaving of skin growth23
Skin biopsy775

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35668TNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence H Reid MD PC Dermatology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1861495012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NORTH STATE OF FRANKLIN ACCESS ROAD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-929-7546",
            "fax_number": "423-929-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 NORTH STATE OF FRANKLIN ACCESS ROAD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-929-7546",
            "fax_number": "423-929-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "35668",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "TN",
            "license": "35668",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "35668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.