Organization Active NPI

Medical Specialists of Knoxville, PLLC

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1285635680
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL SPECIALISTS OF KNOXVILLE, PLLC
Practice address
9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521
Phone
(865) 688-1584
Fax
(865) 688-1581
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Mr. Jeffrey Scott Summers, MDNPI 1528067816
Title
Physician Manager
Phone
(865) 688-1584

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521

Mailing address

9111 Cross Park Dr Ste D200
Knoxville, TN 37923-4521
Phone (865) 688-1584

Other identifiers 1

IdentifierTypeStateIssuer
1285635680MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060811000459 TN Part B Supplier - Clinic/Group Practice 9234132242 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

6612 Maynardville Pike
Knoxville, TN 37918
Phone (865) 661-6304

Practitioners & affiliated clinicians

Practitioners 2

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1285635680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE D200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234521",
            "telephone_number": "865-688-1584",
            "fax_number": "865-688-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 CROSS PARK DR STE D200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234521",
            "telephone_number": "865-688-1584",
            "fax_number": "865-688-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SPECIALISTS OF KNOXVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICIAN MANAGER",
        "authorized_official_telephone_number": "865-688-1584",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285635680",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 28, 2023; 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.