Individual provider Active NPI

Jeffrey A Summers, MD

  • Internal Medicine Physician
  • Kingsport, TN
National Provider Identifier
1528056348
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD34230 Issued in TN
Practice address
4 Sheridan SQ
Suite 200
Kingsport, TN 37660-7390
Phone
(423) 246-7931
Fax
(423) 246-1906
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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 MD34230 TN Primary

Addresses

Primary practice location

4 Sheridan SQ
Suite 200
Kingsport, TN 37660-7390

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 246-7931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD34230TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Medical Education Assistance Corporation Internal Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1528056348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-246-7931",
            "fax_number": "423-246-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607390",
            "telephone_number": "423-246-7931",
            "fax_number": "423-246-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD34230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.