Organization Active NPI

Summit Medical Group, PLLC

Doing business as Summit Medical Group at Northshore

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1033425780
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41919 Issued in TN
Legal business name
SUMMIT MEDICAL GROUP, PLLC
Doing business as
Summit Medical Group at Northshore
Practice address
1924 Pinnacle Pointe Way Ste 100
Knoxville, TN 37922-3700
Phone
(865) 584-5762
Fax
(865) 693-7445
NPI assigned
Aug 19, 2010
Last updated
Dec 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Ed Curtis
Title
Chief Administrative Officer
Phone
(865) 584-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41919 TN Primary

Addresses

Primary practice location

1924 Pinnacle Pointe Way Ste 100
Knoxville, TN 37922-3700

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

Other names 1

  • Summit Medical Group at Northshore Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000793 TN Part B Supplier - Clinic/Group Practice 2860396330 Receives reassigned benefits from 1,153 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1047406Summit Medical Group at Northshore1924 Pinnacle Pointe Way, Ste 100, Knoxville, TN 37922Provider-performed microscopyNov 2, 2027

National Provider Directory

National Provider Directory

Locations

1924 Pinnacle Pointe Way
Ste 100
Knoxville, TN 37922
Phone (865) 584-5762

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1033425780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 PINNACLE POINTE WAY STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223700",
            "telephone_number": "865-584-5762",
            "fax_number": "865-693-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "865-584-4747"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "41919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Group at Northshore",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Medical Group at Northshore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.