Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charlie Etherton, PAC

Individual provider Physician Assistant · NPI 1700990025

Charlie Etherton, PAC is a Physician Assistant in Sevierville, Tennessee. Qualified in 2000, 26 years ago. Practices with Summit Medical Group, PLLC, a 636-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
26
Licensed in
TN
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1124 Fox Meadows Blvd Ste 2
Sevierville, TN 37862-6927
Phone: (865) 453-5530
Fax: (865) 453-2671
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA0842 (TN)

Record details

NPI number1700990025
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedAugust 17, 2006
Last updated in NPPESApril 23, 2020
Certification dateApril 23, 2020
Mailing address1275 Dick Lonas Rd, Knoxville, TN 37909-1382

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Summit Medical Group, Pllc — 636 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Sevierville