NPIMap

Individual provider Active NPI

Kenneth C Reese, MD

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1396780516
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23978 Issued in TN
Practice address
2001 Laurel Ave
Suite 105
Knoxville, TN 37916-1810
Phone
(865) 577-9247
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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 23978 TN Primary

Addresses

Primary practice location

2001 Laurel Ave
Suite 105
Knoxville, TN 37916-1810

Mailing address

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Other identifiers 3

IdentifierTypeStateIssuer
3071267MedicaidTN
3706633OtherTNMEDICARE GROUP
110166468OtherTNRR MEDICARE PIN

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
I20050829000260 TN Practitioner - Internal Medicine 3971534025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

103 Midlake Dr Level
Knoxville, TN 37918-3039
Phone (865) 687-7704

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37849-4016
Phone (865) 938-3627

1275 Dick Lonas Rd
Knoxville, TN 37909-1326

201 E Emory Rd
Powell, TN 37849-4016
Phone (865) 938-3627

7211 Wellington Dr
Knoxville, TN 37919-5968

9333 Park W Blvd
Knoxville, TN 37923-4305

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23978TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jan 20, 2009 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Jan 20, 2009 Accepting new patients
Summit Medical Group, PLLC Internal Medicine Past Accepting new patients
Summit Medical Group, PLLC Internal Medicine Past Accepting new patients

Locations

2001 Laurel Ave
Ste 105
Knoxville, TN 37916
Phone (865) 577-9247

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

200 E Blount Ave
Ste 303
Knoxville, TN 37920
Phone (865) 577-9247

Interoperability endpoints

  • Direct secure messaging: kenneth.reese.1@20785.direct.athenahealth.com

Organizations & group practices 4

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 9

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1396780516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 LAUREL AVE",
            "address_2": "SUITE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161810",
            "telephone_number": "865-577-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "KENNETH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "23978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3071267",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "3706633",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "110166468",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.