Summit Medical Group, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37978 Issued in TN

Legal business name

SUMMIT MEDICAL GROUP, PLLC

Practice address

933 W Race St
Kingston, TN 37763-2123

Phone

(865) 882-0105

NPI assigned

Mar 28, 2012

Last updated

Feb 19, 2018By 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

Ed Curtis

Title

Chief Administrative Officer

Phone

(865) 584-4747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

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.

• Monico Peter Banez, MD

  • Hospitalist Physician
  • Jackson, TN
  • NPI 1962479451
  NPD
• Mary E Bukovitz, MD

  • Pediatrics Physician
  • Morristown, TN
  • NPI 1164517942
  NPD
• Laura Kristin Conrey, PA-C

  • Medical Physician Assistant
  • Hermitage, TN
  • NPI 1205861929
  NPD
• Kelly Talarico, FNP

  • Family Nurse Practitioner
  • Alcoa, TN
  • NPI 1720605439
  NPD

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1639445208",
    "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": "933 W RACE ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632123",
            "telephone_number": "865-882-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "865-584-4747"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "37978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moriah Camak Smith, MSP CCC-SLP
• Buffy Snow, FNP
• Speech Pathology Associates
• Trent Everett Stansbury, D.D.S
• Suzanne Elise Stinnett, M.S., CCC-SLP
• Candace Joy Templeton, FNP
• The Diabetic Super Store Inc
• Therapeutic Solutions, LLC
• Christopher Adam Thompson
• Marcus Alexander Thompson, LCSW

• Family Medicine Physician in Kingston, TN
• Providers in Kingston, 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 Feb 19, 2018; 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.