NPIMap

Organization Active NPI

Summit Medical Group, PLLC

  • Family Medicine Physician
  • Greeneville, TN
National Provider Identifier
1114236080
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT MEDICAL GROUP, PLLC
Practice address
555 Justis Dr
Greeneville, TN 37745-4288
Phone
(423) 783-7965
Fax
(423) 783-7970
NPI assigned
Sep 27, 2010
Last updated
Apr 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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 NU Primary

Addresses

Primary practice location

555 Justis Dr
Greeneville, TN 37745-4288

Mailing address

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

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

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Group PL65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1114236080",
    "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": "555 JUSTIS DR",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454288",
            "telephone_number": "423-783-7965",
            "fax_number": "423-783-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2018-04-17",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.