Individual provider Active NPI

Jake Milton Trey Terry III, NP

  • Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1063371854
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
34884 Issued in TN
Practice address
8635 Middlebrook Pike
Knoxville, TN 37923-1612
Phone
(865) 824-0079
NPI assigned
Jan 19, 2026
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 34884 TN Primary

Addresses

Primary practice location

8635 Middlebrook Pike
Knoxville, TN 37923-1612

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224001300 TN Practitioner - Nurse Practitioner 5395226740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

8635 Middlebrook Pike
Knoxville, TN 37923-1612
Phone (865) 824-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
34884TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC Nurse Practitioner CurrentSince Jan 14, 2026 Accepting new patients
Summit Medical Group, PLLC CurrentSince Jan 14, 2026 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

8635 Middlebrook Pike
Knoxville, TN 37923
Phone (865) 824-0079

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1768780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1063371854",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 MIDDLEBROOK PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379231612",
            "telephone_number": "865-824-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JAKE",
        "middle_name": "MILTON TREY",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-19",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "34884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.