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VIVIAN M CLARK M.D.
NPI 1205889508
Internal Medicine in Elizabethton, TN

Active since May 18, 2006PECOS Enrolled
1503 W ELK AVE, SUITE 5, ELIZABETHTON, TN 37643(423) 542-0400(423) 542-3265 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 17, 2018, Oct 19, 2017 (2 updates tracked since 2017).

About Vivian M Clark M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVIAN M CLARK M.D. (NPI 1205889508) is an individual internal medicine provider in Elizabethton, Tennessee, licensed in Tennessee (39360) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1205889508
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameVIVIAN M CLARKCredential: M.D.
Location Address1503 W ELK AVE, SUITE 5Elizabethton, TN 37643-2876
Mailing Address1503 W Elk Ave, Suite 5Elizabethton, TN 37643-2876 · (423) 542-0400 · Fax (423) 542-3265
Phone(423) 542-0400
Fax(423) 542-3265
Sole ProprietorYes
Enumeration DateMay 18, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1205889508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in TN · 39360✔ Licensed in TN · MD39360
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1503 W ELK AVE, Elizabethton, TN 37643
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Other Names 1

Former Name (1)Vivian L. Mercado

Secondary Practice Locations 4

Location 11633 Hillview DrElizabethton, TN 37643-4115 · Phone (423) 282-1480 · Fax (423) 928-1353
Location 21666 Hillview DrElizabethton, TN 37643-4116 · Phone (423) 282-1480 · Fax (423) 928-1353
Location 31200 Spruce LnElizabethton, TN 37643-4301 · Phone (423) 282-1480 · Fax (423) 928-1353
Location 4146 Buck Creek RdRoan Mountain, TN 37687-3497 · Phone (423) 282-1480 · Fax (423) 928-1353

Other Identifiers 3

Medicaid3326510TN
Other4146001TN · Bcbs Of Tennessee
OtherTN0109TN · John Deereuhc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vivian M Clark M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Vivian Clark reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ipc Pac Healthcare Services Of Tennessee PC
17 mi
Internal Medicine
1 MEDICAL PARK BLVD
Bristol, TN 37620
  • Reassigned Medicare billing, Tennessee enrollment
  • 230 clinicians in this Medicare group
NPI 1104277656 (423) 844-1121
Cs Pacs 3 Southeast, LLC
85 mi
Hospitalist
1600 BLAND ST
Bluefield, WV 24701
  • Reassigned Medicare billing, Tennessee enrollment
  • 227 clinicians in this Medicare group
NPI 1154104958 (304) 327-2485
Southeastern Physician Services PC
114 mi
Hospitalist
990 OAK RIDGE TPKE
Oak Ridge, TN 37830
  • Reassigned Medicare billing, Tennessee enrollment
  • 1,085 clinicians in this Medicare group
NPI 1083835441 (865) 481-1000
Nv Pacs 2 LLC
1,838 mi
Hospitalist
10550 PARK RUN DR
Las Vegas, NV 89144
  • Reassigned Medicare billing, Tennessee enrollment
  • 253 clinicians in this Medicare group
NPI 1427534809 (865) 693-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
485 services133 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
129 services72 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
93 services84 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
60 services59 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
47 services44 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
30 services23 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37643 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%315 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
1 supplier18 claims18 services$23.35 avg. paid by Medicare
Urinary catheter anchoring device, leg strap, each A4334
DME-Orthotic Devices · category DF000N
1 supplier25 claims25 services$4.73 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers22 claims32 services$8.00 avg. paid by Medicare
Collagen based wound filler, dry form, sterile, per gram of collagen A6010
DME-Medical/Surgical Supplies · category DA023N
3 suppliers16 claims434 services$29.87 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
3 suppliers17 claims630 services$6.90 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212
DME-Medical/Surgical Supplies · category DA023N
2 suppliers11 claims190 services$9.32 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUNTAIN EMPIRE MEDICAL AND SURGICAL ASSOCIATES PLLC
Internal Medicine
1503 W ELK AVE, SUITE 8
ELIZABETHTON, TN 37643
Carter County (423) 542-0400
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Specialist
1503 W ELK AVE, SUITE 8
ELIZABETHTON, TN 37643
Carter County (423) 543-8619
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Specialist
1503 W ELK AVE, SUITE 3B
ELIZABETHTON, TN 37643
Carter County (423) 543-7168
TAMMY L KITCHENS M.D.
Pediatrics
1503 W ELK AVE, SUITE 12
ELIZABETHTON, TN 37643
Carter County (423) 547-9400
JONATHAN SCOTT BREMER M.D.
Internal Medicine
1503 W ELK AVE, SUITE 8
ELIZABETHTON, TN 37643
Carter County (423) 542-0400
MR. BOBBY DEAN REYNOLDS II FNP
Nurse Practitioner (Family)
1503 W ELK AVE
ELIZABETHTON, TN 37643
Carter County (423) 543-6660
DR. SCOTT O CAUDLE MD
General Practice
1503 W ELK AVE, SUITE 1
ELIZABETHTON, TN 37643
Carter County (423) 543-8619
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Orthopaedic Surgery
1503 W ELK AVE, SUITE 3
ELIZABETHTON, TN 37643
Carter County (423) 542-3806

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vivian Clark's NPI number?

The NPI number for Vivian Clark is 1205889508. It was assigned to this individual provider in the NPPES registry on May 18, 2006. The provider is also known as Vivian L. Mercado.

Where is Vivian Clark located?

Vivian Clark practices at 1503 W Elk Ave Suite 5, Elizabethton, TN 37643. The listed phone number is (423) 542-0400.

What is Vivian Clark's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Vivian Clark enrolled in Medicare?

Yes. Vivian Clark is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Vivian Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vivian Clark reassigns Medicare benefits to 4 organizations: Ipc Pac Healthcare Services Of Tennessee PC (Bristol, TN), Cs Pacs 3 Southeast, LLC (Bluefield, WV), Southeastern Physician Services PC (Oak Ridge, TN) and Nv Pacs 2 LLC (Las Vegas, NV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vivian Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Vivian Clark was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.