Individual provider Active NPI

Justin Robert Cecil, PA-C

  • Medical Physician Assistant
  • Lenoir City, TN
National Provider Identifier
1487834107
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1552 Issued in TN
Practice address
721 Highway 321 N Ste C
Lenoir City, TN 37771-5003
Phone
(865) 986-3283
NPI assigned
Nov 9, 2007
Last updated
Nov 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1552 TN Primary

Addresses

Primary practice location

721 Highway 321 N Ste C
Lenoir City, TN 37771-5003

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1510405MedicaidTN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071210000304 TN Practitioner - Physician Assistant 7618066978 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

101 Cherokee PL
Suite 107
Loudon, TN 37774-4162
Phone (865) 408-9344

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

721 Hwy 321 N
Suite C
Lenoir City, TN 37771-5003
Phone (865) 986-3283

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1552TNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Jan 1, 2008 Accepting new patients
Summit Medical Group, PLLC CurrentSince Jan 1, 2008 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients

Locations

10215 Kingston Pike
Ste 100
Knoxville, TN 37922
Phone (865) 691-0733

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

721 Highway 321 N
Ste C
Lenoir City, TN 37771
Phone (865) 986-3283

Interoperability endpoints

  • Direct secure messaging: justin.cecil.1@20785.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1487834107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "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": "721 HIGHWAY 321 N STE C",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377715003",
            "telephone_number": "865-986-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECIL",
        "first_name": "JUSTIN",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510405",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

Verify at the official NPI Registry.