NPIMap

Organization Active NPI

Summit Medical Group PLLC

Doing business as Summit Medical Group at Pistol Creek

  • Family Medicine Physician
  • Alcoa, TN
National Provider Identifier
1508742495
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT MEDICAL GROUP PLLC
Doing business as
Summit Medical Group at Pistol Creek
Practice address
418 Marilyn LN
Alcoa, TN 37701-2118
Phone
(865) 984-6203
Fax
(844) 689-0752
NPI assigned
Aug 14, 2025
Last updated
Aug 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT MEDICAL GROUP PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Jennifer Raney
Title
Provider Enrollment Supervisor
Phone
(865) 584-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

418 Marilyn LN
Alcoa, TN 37701-2118

Mailing address

1275 Dick Lonas Rd
Knoxville, TN 37909-1382
Phone (865) 584-4747

Other names 1

  • Summit Medical Group at Pistol Creek Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2329933Summit Medical Group at Pistol Creek418 Marilyn LN, Alcoa, TN 37701Certificate of waiverSep 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Group PLLC65 organizations share this tax ID, including this one
Part of
Summit Medical Group PLLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1508742495",
    "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",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 MARILYN LN",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012118",
            "telephone_number": "865-984-6203",
            "fax_number": "844-689-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT MEDICAL GROUP PLLC",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "RANEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "865-584-4747"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Group at Pistol Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alcoa, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.