NPIMap

Organization Active NPI

Summit Medical Group PLLC

Doing business as Brentwood Children's Clinic, a division of Summit Medical Group

  • Pediatrics Physician
  • Brentwood, TN
National Provider Identifier
1942030648
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SUMMIT MEDICAL GROUP PLLC
Doing business as
Brentwood Children's Clinic, a division of Summit Medical Group
Practice address
95 Seaboard LN Ste 201
Brentwood, TN 37027-3040
Phone
(615) 261-1210
Fax
(833) 973-3532
NPI assigned
Aug 6, 2024
Last updated
Jan 9, 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 Jan 9, 2025

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

Authorized official

Name
Sabrina Jill Spahr
Title
Provider Enrollment Coordinator
Phone
(865) 500-2143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

95 Seaboard LN Ste 201
Brentwood, TN 37027-3040

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 500-2143

Other names 1

  • Brentwood Children's Clinic, a division of Summit Medical Group 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
44D0306562Brentwood Children's Clinic95 Seaboard Lane Suite 201, Brentwood, TN 37027Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dr's Passarello Ferguson64 organizations share this tax ID, including this one
Part of
Dr's Passarello Ferguson

Organizations with this tax ID in the same state 13

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

View all 13

Locations

95 Seaboard Ln
Ste 2021
Brentwood, TN 37027
Phone (615) 261-1210

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1942030648",
    "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": "865-500-2143",
            "fax_number": "865-381-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 SEABOARD LN STE 201",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273040",
            "telephone_number": "615-261-1210",
            "fax_number": "833-973-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT MEDICAL GROUP PLLC",
        "enumeration_date": "2024-08-06",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "SPAHR",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "865-500-2143"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Children's Clinic, a division of Summit Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brentwood Children's Clinic, a division of Summit Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brentwood, TN

Sources for this page

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