NPIMap

Individual provider Active NPI

Bradley Jason Davis, M.D.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1326203548
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47173 Issued in TN
Practice address
1819 Clinch Ave Ste 114
Knoxville, TN 37916
Phone
(865) 524-1631
Fax
(865) 541-1727
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 47173 TN Primary

Addresses

Primary practice location

1819 Clinch Ave Ste 114
Knoxville, TN 37916

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1525131MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000258 TN Practitioner - Internal Medicine 0042488470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

1819 W Clinch Ave
Suite 114
Knoxville, TN 37916-2435
Phone (865) 524-1631

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47173TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health System Inc CurrentSince Jun 5, 2012 Accepting new patients
University Health System, Inc Internal Medicine CurrentSince Jun 5, 2012 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Apr 1, 2018 Accepting new patients
Summit Medical Group, PLLC Internal Medicine Past Accepting new patients
Blount Hospitalists PC Past Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

1819 Clinch Ave
Ste 114
Knoxville, TN 37916
Phone (865) 524-1631

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

1924 Alcoa Hwy
#56
Knoxville, TN 37920
Phone (865) 305-9081

Interoperability endpoints

  • Direct secure messaging: bradley.davis.1@20785.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1326203548",
    "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": "1819 CLINCH AVE STE 114",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-524-1631",
            "fax_number": "865-541-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRADLEY",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "47173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525131",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.