Tavis D. Clonch, P.A.
NPI 1629752514ActiveIndividual· Physician Assistant, Surgical· Johnson City, TN
Physician Assistant, Surgical (P.A.) with Blue Ridge Medical Management Corporation and 1 other group, practicing in Johnson City, Tennessee. 309 Medicare patients in 2024, $29,406 paid; all of their 221 Part D prescriptions were generic. Medtronic, Inc. reported $17.03 in payments in 2025, mostly food and beverage. Lists Johnson City Medical Center as a hospital affiliation.
Overview
| NPI | 1629752514 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.A. |
| Sole proprietor | No |
| NPI issued | Jun 12, 2023 |
| Last updated in NPPES | Oct 20, 2026 |
| Certified by provider | Oct 20, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | 5560 | TN |
| Physician Assistant, Surgical | 363AS0400X | 0110009515 | VA |
| Physician Assistant | 363A00000X | 0110009515 | VA |
| Physician Assistant | 363A00000X | 5560 | TN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TN); Practitioner - Physician Assistant (VA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 309 |
|---|---|
| Services billed | 2,979 across 60 procedure codes |
| Paid by Medicare | $29,406 |
Part D prescriptions in 2024
| Prescriptions (claims) | 221 · 225 30-day fills |
|---|---|
| Patients | 131 |
| Total drug cost | $1,273 |
| Generic share | 100% of claims |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Blue Ridge Medical Management CorporationAbingdon, VA · 289 clinicians
- Campbell Clinic, PCBristol, TN · 239 clinicians
Hospital affiliation
- Johnson City Medical CenterJohnson City, TN
Industry payments (Open Payments)
- 2025$17.03 · 1 payment from 1 company
- 2024$58.44 · 3 payments from 3 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Medtronic, Inc. | $17.03 | 1 |
What the 2025 payments were for
- Food and Beverage$17.03 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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