Individual provider Active NPI

Leslie M Fitzgerald, M.D.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1396188975
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53803 Issued in TN
Practice address
1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909
Phone
(186) 558-4474
Fax
(865) 584-1363
NPI assigned
Apr 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 53803 TN Primary

Addresses

Primary practice location

1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909

Mailing address

325 N State of Franklin Rd
Johnson City, TN 37604-6056
Phone (423) 439-6283

Other practice location 1

325 N State Of Franklin Rd
Johnson City, TN 37604-6056
Phone (423) 439-6283

Other identifiers 1

IdentifierTypeStateIssuer
Q031939MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180122002384 TN Practitioner - Internal Medicine 6103185046 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 218-7011

7565 Dannaher Dr
Powell, TN 37849-4029
Phone (865) 859-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53803TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Sep 18, 2017 Accepting new patients
App of Tennessee HM, PLLC CurrentSince Sep 1, 2019 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Sep 18, 2017 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients

Locations

110 Hospital Dr
Jefferson Cty, TN 37760
Phone (865) 471-2431

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

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

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1396188975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046056",
            "telephone_number": "423-439-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "186-558-4474",
            "fax_number": "865-584-1363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046056",
            "country_code": "US",
            "telephone_number": "423-439-6283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "LESLIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "53803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031939",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.