Provider Demographics
NPI:1952331647
Name:SUMMIT VIEW HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:SUMMIT VIEW HEALTH SERVICES LLC
Other - Org Name:HALLMARK HEALTH SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, NHA
Authorized Official - Phone:865-675-6444
Mailing Address - Street 1:PO BOX 23376
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-1376
Mailing Address - Country:US
Mailing Address - Phone:865-675-6444
Mailing Address - Fax:865-218-6133
Practice Address - Street 1:10805 HARDING DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3240
Practice Address - Country:US
Practice Address - Phone:865-675-6444
Practice Address - Fax:865-218-6133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207SG0201X, 363LF0000X, 363LG0600X
TN225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446604OtherMEDICARE
TN0446604Medicaid
TN3728981Medicaid
TN0446604Medicaid
TN0446604OtherMEDICARE