SUMMIT MEDICAL GROUP PLLC - NPI 1508742495 - Family Medicine in Alcoa, TN

Q: What is Summit Medical Group PLLC's NPI number?

The NPI number for Summit Medical Group PLLC is 1508742495. It was assigned to this organization in the NPPES registry on August 14, 2025. The provider is doing business as Summit Medical Group at Pistol Creek.

Q: What is Summit Medical Group PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Summit Medical Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT MEDICAL GROUP PLLC (NPI 1508742495), doing business as Summit Medical Group At Pistol Creek, is a healthcare organization registered as a family medicine in Alcoa, Tennessee and active in the NPI registry since August 2025. The organization holds a CLIA Waiver certificate valid through September 7, 2027 and lists Jennifer Raney, Provider Enrollment Supervisor, as its authorized official.

NPPES Registry Identity

NPI1508742495

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameSUMMIT MEDICAL GROUP PLLC

Location Address418 MARILYN LNAlcoa, TN 37701-2118

Mailing Address1275 Dick Lonas RdKnoxville, TN 37909-1382 · (865) 584-4747 · Fax (865) 381-1509

Phone(865) 984-6203

Fax(844) 689-0752

Organization SubpartYes

Authorized OfficialJennifer RaneyProvider Enrollment Supervisor · (865) 584-4747

Enumeration DateAugust 14, 2025

NPPES CertifiedAugust 14, 2025

✔ NPI 1508742495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

418 MARILYN LN, Alcoa, TN 37701

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Other Names 1

Doing Business AsSummit Medical Group At Pistol Creek

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2329933

Summit Medical Group At Pistol Creek · Alcoa, TN

Active · expires Sep 7, 2027

CLIA Number44D2329933

Laboratory TypePhysician Office

Certificate Effective DateSeptember 8, 2025

Certificate Expiration DateSeptember 7, 2027

Laboratory DirectorDr. Richard M. Gaddis

Laboratory Phone(865) 984-6203

Laboratory LocationSummit Medical Group At Pistol Creek418 Marilyn Ln, Alcoa, TN 37701

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE BANKERD F.N.P.

Nurse Practitioner (Family)