Summit Medical Group, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUMMIT MEDICAL GROUP, PLLC

Doing business as

Athens Medical Group

Practice address

1031 W Madison Ave Ste 1
Athens, TN 37303-3496

Phone

(423) 745-6575

NPI assigned

Jun 25, 2020

Last updated

Jun 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Allison Hall

Title

Credentialing Coordinator

Phone

(865) 584-4747

Specialties & licenses 1

Addresses

Other names 1

• Athens Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan A Kerr, PA

  • Physician Assistant
  • Knoxville, TN
  • NPI 1700234523
  NPD
• Christina Rebecca Calott, PA-C

  • Physician Assistant
  • Asheville, NC
  • NPI 1043609472
  NPD
• Carley Jo Mardini, FNP-C

  • Family Nurse Practitioner
  • Las Cruces, NM
  • NPI 1518585777
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1497371496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091382",
            "telephone_number": "865-584-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 W MADISON AVE STE 1",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373033496",
            "telephone_number": "423-745-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "865-584-4747"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athens Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Petrinjak Sullins, OD
• Stuart Sullins, O.D.
• Timothy Blake Sullins, OD
• William David Sullins III, O.D.
• Michael P Sumida, M.D.
• Daniel Surman
• Suncica Sunshine Svalina, DPT
• Abby Swaim, RDH
• Allen B Tacke, LPC
• Tennessee Cancer Specialists

• Family Medicine Physician in Athens, TN
• Providers in Athens, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.