Individual provider Active NPI

Teresa Long-Craft-Clark

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1093145419
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18151 Issued in TN
Practice address
2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333
Phone
(865) 909-0090
Fax
(865) 909-9883
NPI assigned
Nov 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 158895 TN
Family Nurse Practitioner 363LF0000X 18151 TN Primary

Addresses

Primary practice location

2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333

Mailing address

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Other names 1

  • Teresa Long-Craft Former name

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
I20140303000326 TN Practitioner - Nurse Practitioner 7012147523

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1225 E Weisgarber Rd
Knoxville, TN 37909-2604

128 Mountain Meadow LN
Clinton, TN 37716-7137

7725 W Reno Ave
Suite 150
Oklahoma City, OK 73127-9712

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158895TNMDRegistered Nurse
18151TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC CurrentSince Jul 1, 2017 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919
Phone 8659090090 ext. 222

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1093145419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "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": "2240 SUTHERLAND AVE",
            "address_2": "SUITE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192333",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG-CRAFT-CLARK",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "158895",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "LONG-CRAFT",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.