NPIMap

Individual provider Active NPI

John M Robertson, MD

  • Family Medicine Physician
  • Harrogate, TN
National Provider Identifier
1881858215
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53166 Issued in MN
Practice address
170 Beech St
Suite 1
Harrogate, TN 37752-8251
Phone
(423) 869-3684
Fax
(423) 869-5460
NPI assigned
Jul 15, 2008
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53166 MN Primary
Family Medicine Physician 207Q00000X 47585 TN

Addresses

Primary practice location

170 Beech St
Suite 1
Harrogate, TN 37752-8251

Mailing address

170 Beech St Ste 1
P.O. Box 750
Harrogate, TN 37752-8251
Phone (423) 869-3684

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
I20110713000376 TN Practitioner - Family Practice 4789878505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Clinic of Harrogate, P.C.Group PAC ID 5395807010, 7 clinicians

Practice addresses (Care Compare)

170 Beech St
Suite 1
Harrogate, TN 37752-8251
Phone (423) 869-3684

Hospital & facility affiliations

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
47585TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Clinic of Harrogate, P.C. Family Medicine CurrentSince Jul 5, 2011 Accepting new patients

Locations

170 Beech St
Harrogate, TN 37752
Phone (423) 869-3684

170 Beech St
Ste 1
Harrogate, TN 37752
Phone (423) 869-3684

209 Irish Cemetery Rd
Tazewell, TN 37879
Phone (423) 626-2225

209 Irish Cemetery Rd
Ste 1
Tazewell, TN 37879

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFBGBA
  • Direct secure messaging: john.robertson@fmcoh.eclinicaldirectplus.com

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1881858215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 BEECH ST STE 1",
            "address_2": "P.O. BOX 750",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528251",
            "telephone_number": "423-869-3684",
            "fax_number": "423-869-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 BEECH ST",
            "address_2": "SUITE 1",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528251",
            "telephone_number": "423-869-3684",
            "fax_number": "423-869-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53166",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrogate, TN

Sources for this page

Verify at the official NPI Registry.