HOLLY RENEE CLEMONS M.D.
NPI 1528354560
Family Medicine in Sullivan, IL

Q: What is Holly Clemons's NPI number?

The NPI number for Holly Clemons is 1528354560. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Q: What is Holly Clemons's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Clemons was last updated on December 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 28, 2011PECOS Enrolled

7 HAWTHORNE LN STE A, SULLIVAN, IL 61951(217) 728-8441(217) 728-8678 Get Directions Write a Review

NPPES record last updated: December 11, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 11, 2023, Jun 15, 2023, Jan 3, 2023 and 1 more (4 updates tracked since 2021).

On this page

About Holly Renee Clemons M.d. NPPES

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

HOLLY RENEE CLEMONS M.D. (NPI 1528354560) is an individual family medicine provider in Sullivan, Illinois, licensed in Illinois (036160654) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528354560

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameHOLLY RENEE CLEMONSCredential: M.D.

Location Address7 HAWTHORNE LN STE ASullivan, IL 61951-9490

Mailing Address777 Hemlock StMacon, GA 31201-2102 · (478) 633-5500 · Fax (478) 784-5496

Phone(217) 728-8441

Fax(217) 728-8678

Sole ProprietorNo

Enumeration DateJune 28, 2011

Last NPPES UpdateDecember 11, 20234 updates tracked since enumeration

NPPES CertifiedDecember 11, 2023

✔ NPI 1528354560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IL · 036160654✔ Licensed in GA · 71921✔ Licensed in AZ · 68597

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

7 HAWTHORNE LN STE A, Sullivan, IL 61951

Open in Google Maps ↗

Secondary Practice Locations 2

Location 121300 N John Wayne Pkwy Ste 115Maricopa, AZ 85139-8978 · Phone (520) 426-3424

Location 2777 Hemlock StMacon, GA 31201-2102 · Phone (478) 633-5500 ext. 5500 · Fax (478) 784-5496

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly Renee Clemons 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

Medicare enrollment records show Holly Clemons reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Southeast Permanente Medical Group

460 mi

Internal Medicine

3495 PIEDMONT ROAD NE, NINE PIEDMONT CENTER
Atlanta, GA 30305

Reassigned Medicare billing, Georgia enrollment
1,389 clinicians in this Medicare group

NPI 1245266956 (404) 364-3821

The Emory Clinic Inc

465 mi

Internal Medicine

1365 CLIFTON RD NE
Atlanta, GA 30322

Reassigned Medicare billing, Georgia enrollment
4,840 clinicians in this Medicare group

NPI 1396798229 (404) 778-2144

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

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

16 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61951 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

Other Providers at the Same Location NPPES

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

COURTNEY MICHELLE WILLIAMS APRN

Nurse Practitioner (Family)

7 HAWTHORNE LN STE A
SULLIVAN, IL 61951

Moultrie County (217) 728-8441

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 Holly Clemons's NPI number?

The NPI number for Holly Clemons is 1528354560. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Where is Holly Clemons located?

Holly Clemons practices at 7 Hawthorne Ln Ste A, Sullivan, IL 61951. The listed phone number is (217) 728-8441.

What is Holly Clemons's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Holly Clemons enrolled in Medicare?

Yes. Holly Clemons is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Holly Clemons's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Clemons reassigns Medicare benefits to 2 organizations: The Southeast Permanente Medical Group (Atlanta, GA) and The Emory Clinic Inc (Atlanta, GA). 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 Holly Clemons'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 Holly Clemons was last updated on December 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.