Individual provider Active NPI

Justin Saylor, PA-C

  • Medical Physician Assistant
  • Jefferson City, TN
National Provider Identifier
1689393985
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5194 Issued in TN
Practice address
380 W Broadway Blvd
Jefferson City, TN 37760-2602
Phone
(865) 475-4742
Fax
(833) 908-2080
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5194 TN Primary

Addresses

Primary practice location

380 W Broadway Blvd
Jefferson City, TN 37760-2602

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221129002614 TN Practitioner - Physician Assistant 9436527231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37849-4016
Phone (865) 938-3627

1275 Dick Lonas Rd
Knoxville, TN 37909-1326

201 E Emory Rd
Powell, TN 37849-4016
Phone (865) 938-3627

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5194TNMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Oct 1, 2022 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 1, 2022 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

Locations

380 W Broadway Blvd
Jefferson City, TN 37760
Phone (865) 450-9361

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

Interoperability endpoints

  • Direct secure messaging: justin.saylor.1@20785.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1689393985",
    "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": "380 W BROADWAY BLVD",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602602",
            "telephone_number": "865-475-4742",
            "fax_number": "833-908-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYLOR",
        "first_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "5194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.