NPIMap

Organization Active NPI

Summit Medical Group,PLLC

  • Pediatrics Physician
  • Knoxville, TN
National Provider Identifier
1669031837
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SUMMIT MEDICAL GROUP,PLLC
Practice address
125 Huxley Rd
Knoxville, TN 37922-3197
Phone
(865) 518-0084
Fax
(865) 558-5669
NPI assigned
Jun 11, 2019
Organization subpart
Yes
Parent organization
SUMMIT MEDICAL GROUP,PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Ed Curtis, CMPE
Title
Ceo
Phone
(865) 584-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

125 Huxley Rd
Knoxville, TN 37922-3197

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

Other practice location 1

2587 Willow Point Way
Knoxville, TN 37931-3162
Phone (865) 824-1522

Other practice location 2

11021 Chapman Hwy
Seymour, TN 37865
Phone (865) 205-3028

Other identifiers 1

IdentifierTypeStateIssuer
Q053040MedicaidTN

Other names 1

  • Pediatric Clinic 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
44D2175253SMG Pediatric Clinic West125 Huxley Rd, Knoxville, TN 37922ComplianceDec 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Norwood Family Practice64 organizations share this tax ID, including this one
Part of
Norwood Family Practice

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

Locations

11021 Chapman Hwy
Seymour, TN 37865
Phone (865) 205-3028

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1669031837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "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": "125 HUXLEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223197",
            "telephone_number": "865-518-0084",
            "fax_number": "865-558-5669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2587 Willow Point Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379313162",
            "country_code": "US",
            "telephone_number": "865-824-1522",
            "fax_number": "865-558-5692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11021 Chapman Hwy",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "TN",
            "postal_code": "37865",
            "country_code": "US",
            "telephone_number": "865-205-3028",
            "fax_number": "865-558-5698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP,PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT MEDICAL GROUP,PLLC",
        "enumeration_date": "2019-06-11",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "865-584-4747",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q053040",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.