Individual provider Active NPI

Brent Webb, D.O.

  • Family Medicine Physician
  • Jacksboro, TN
National Provider Identifier
1336178748
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO1138 Issued in TN
Practice address
2545 Jacksboro Pike
Jacksboro, TN 37757-4847
Phone
(423) 566-8181
Fax
(423) 562-9692
NPI assigned
Jun 30, 2006
Last updated
Oct 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO1138 TN Primary

Addresses

Primary practice location

2545 Jacksboro Pike
Jacksboro, TN 37757-4847

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1512219MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050630000380 TN Practitioner - Family Practice 9739125691 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1138TNMDClinical Psychologist
DO1138TNMDFamily Medicine Physician
3226OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Tennessee, PC CurrentSince Apr 14, 2018 Accepting new patients
Summit Medical Group, PLLC Family Medicine CurrentSince Oct 1, 2017 Accepting new patients
Afc Physicians of Tennessee, PC Family Medicine CurrentSince Apr 14, 2018 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 1, 2017 Accepting new patients
Cherokee Health Systems Family Medicine Past Accepting new patients
Summit Medical Group PLLC Family Medicine PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Abercrombie Radiological Consultants Inc Past Accepting new patients

Locations

1015 Hunters Xing
Alcoa, TN 37701
Phone (856) 238-2006

2545 Jacksboro Pike
Jacksboro, TN 37757
Phone (423) 352-6090

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

9203 Kingston Pike
Knoxville, TN 37922
Phone (865) 299-6192

2212 Jacksboro Pike
La Follette, TN 37766
Phone (423) 201-9287

6606 Charlotte Pike
Ste 104
Nashville, TN 37209
Phone (615) 630-6095

Organizations & group practices 8

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1336178748",
    "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": "2545 JACKSBORO PIKE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377574847",
            "telephone_number": "423-566-8181",
            "fax_number": "423-562-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "BRENT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO1138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512219",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksboro, TN

Sources for this page

Verify at the official NPI Registry.