Organization Active NPI

Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1275824658
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUMMIT MEDICAL GROUP, PLLC
Practice address
1819 Clinch Ave
Suite 114
Knoxville, TN 37916-2434
Phone
(865) 524-1631
Fax
(865) 546-3628
NPI assigned
Apr 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1819 Clinch Ave
Suite 114
Knoxville, TN 37916-2434

Mailing address

1275 Dick Lonas Rd
Knoxville, TN 37909-1382
Phone (865) 584-4747

Other practice location 1

7323 Chapman Hwy Ste 170
Knoxville, TN 37920-6758
Phone (865) 579-0599

Other names 1

  • Summit Medical Group at Fort Sanders 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
44D0312411Summit Medical Group/Fort Sanders1819 Clinch Ave Ste 114, Knoxville, TN 37916Certificate of waiverFeb 26, 2028
44D2134386Summit Medical Group of South Knoxville7323 Chapman Hwy, Ste 170, Knoxville, TN 37920Certificate of waiverApr 21, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1275824658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091382",
            "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": "1819 CLINCH AVE",
            "address_2": "SUITE 114",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-524-1631",
            "fax_number": "865-546-3628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7323 Chapman Hwy Ste 170",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379206758",
            "country_code": "US",
            "telephone_number": "865-579-0599",
            "fax_number": "865-851-7358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHEIF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "865-584-4747"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Group at Fort Sanders",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Medical Group at Fort Sanders",
            "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 Apr 4, 2019; 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.