Active NPI
Summit Medical Group, PLLC
- Pediatrics Physician
- Morristown, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- SUMMIT MEDICAL GROUP, PLLC
- Doing business as
- Hometown Pediatric Morristown
- Practice address
- 1817 W Morris Blvd
Morristown, TN 37813-2837 - Phone
- (423) 581-3904
- Fax
- (423) 581-6120
- NPI assigned
- Jan 30, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra Bowles
- Title
- Provider Enrollment Coordinator
- Phone
- (655) 844-7478
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
1817 W Morris Blvd
Morristown, TN 37813-2837
Mailing address
1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747
Other practice location 1
629 Middle Creek Rd
Sevierville, TN 37862-5014
Phone (865) 453-9980
Other practice location 2
125 Mossy Creek Drive
Jefferson City, TN 37760-2421
Phone (865) 475-5377
Other names 1
- Hometown Pediatric Morristown
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0311809 | Hometown Pediatric Morristown | Accreditation | Mar 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
125 Mossy CRK Dr
Jefferson City, TN 37760
Phone (865) 475-5377
9333 Park West Blvd
Knoxville, TN 37923
Phone (865) 531-4600
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Knoxville, TN
- NPI 1619124930
-
- Adult Health Nurse Practitioner
- Knoxville, TN
- NPI 1528370350
-
- Physician Assistant
- Knoxville, TN
- NPI 1750786059
-
- Family Nurse Practitioner
- Maryville, TN
- NPI 1366054934
-
- Pediatric Nurse Practitioner
- Knoxville, TN
- NPI 1164034013
-
- Family Nurse Practitioner
- Knoxville, TN
- NPI 1639495716
-
- Physician Assistant
- Knoxville, TN
- NPI 1174981757
-
- Pediatric Nurse Practitioner
- Morristown, TN
- NPI 1518393834
-
- Pediatrics Physician
- Morristown, TN
- NPI 1144259920
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517270400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1743120000000",
"number": "1285132845",
"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": "1817 W MORRIS BLVD",
"city": "MORRISTOWN",
"state": "TN",
"postal_code": "378132837",
"telephone_number": "423-581-3904",
"fax_number": "423-581-6120"
}
],
"practiceLocations": [
{
"address_1": "629 Middle Creek Rd",
"address_purpose": "LOCATION",
"city": "Sevierville",
"state": "TN",
"postal_code": "378625014",
"country_code": "US",
"telephone_number": "865-453-9980",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "125 Mossy Creek Drive",
"address_purpose": "LOCATION",
"city": "Jefferson City",
"state": "TN",
"postal_code": "377602421",
"country_code": "US",
"telephone_number": "865-475-5377",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUMMIT MEDICAL GROUP, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-30",
"last_updated": "2025-03-28",
"certification_date": "2025-03-26",
"status": "A",
"authorized_official_last_name": "BOWLES",
"authorized_official_first_name": "SANDRA",
"authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
"authorized_official_telephone_number": "655-844-7478"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hometown Pediatric Morristown",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Morristown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.