Madison Stephens Boles, MD
Individual provider Active NPI Internal Medicine Physician · Jefferson City, TN
NPI 1467071969 · NPPES record last updated Feb 26, 2025
Key facts
- NPI
- 1467071969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 71323 (TN)
- Practice address
- 380 W Broadway Blvd
Jefferson City, TN 37760-2602 - Phone
- (865) 475-4742
- NPI assigned
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Tennessee, HSC, College of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Volunteer Healthcare Services, Inc.
Summit Medical Group, PLLC
Practice addresses (Care Compare)
3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495
380 W Broadway Blvd
Jefferson City, TN 37760-5279
Phone (865) 475-4742
Hospital & facility affiliations
- Tennova Healthcare-Jefferson Memorial Hospital
- Morristown Hamblen Hospital Association
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240814001015 | TN | Practitioner - Internal Medicine |
4587095294 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71323 | TN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, PLLC | Internal Medicine | Current |
Accepting new patients |
| Summit Medical Group, PLLC | Internal Medicine | Current |
Accepting new patients |
| Summit Medical Group, PLLC | Internal Medicine | Past | Accepting new patients |
Locations
380 W Broadway Blvd
Jefferson City, TN 37760
Phone (865) 450-9361
1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627
1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909
Interoperability endpoints
- madison.boles.1@20785.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 71323 | TN | Yes |
Addresses
Primary practice location
380 W Broadway Blvd
Jefferson City, TN 37760-2602
Mailing address
1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747
Other providers in Jefferson City, TN
- Blair E. Cohen DDS, PLLC
- Blair E. Cohen, DDS, PLLC
- William Lafayette Blevins
- Mark James Blosser
- Ida Mae Boatman-Goussios
- Miguel A Bonet
- Keiko Bovee
- Morgan Frazier Bowlin
- Broken Arrow
- Lisa Carol Bryant
All providers in Jefferson City, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.