Individual provider Active NPI

Richard A Glover, MD

  • Pediatrics Physician
  • Knoxville, TN
National Provider Identifier
1124012513
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD21285 Issued in TN
Practice address
1341 Branton Blvd
Ste 102
Knoxville, TN 37922-8537
Phone
(865) 690-8778
Fax
(865) 694-7507
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD21285 TN Primary

Addresses

Primary practice location

1341 Branton Blvd
Ste 102
Knoxville, TN 37922-8537

Mailing address

1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909-2675
Phone (865) 584-4747

Other identifiers 2

IdentifierTypeStateIssuer
Q007840MedicaidTN
4048686OtherTNBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022001956 TN Practitioner - Pediatric Medicine 1456604495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD21285TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jul 1, 2018 Accepting new patients
Summit Medical Group, PLLC CurrentSince Jul 1, 2018 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

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

1341 Branton Blvd
Ste 102
Knoxville, TN 37922
Phone (865) 690-8778

Interoperability endpoints

  • Direct secure messaging: richard.glover.1@20785.direct.athenahealth.com

Organizations & group practices 5

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1124012513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092675",
            "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": "1341 BRANTON BLVD",
            "address_2": "STE 102",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379228537",
            "telephone_number": "865-690-8778",
            "fax_number": "865-694-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD21285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007840",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4048686",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.