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

Kenneth Nickle, DO

Individual provider Family Medicine Physician · NPI 1790849081

Kenneth Nickle, DO is a Family Practice in Greeneville, Tennessee. Graduated from West Virginia School of Osteopathic Medicine in 2004, 22 years ago. Practices with Summit Medical Group, PLLC, a 636-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
22
Trained at
West Virginia School of Osteopathic Medicine
Licensed in
TN
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

555 Justis Dr
Greeneville, TN 37745-4288
Phone: (423) 783-7965
Fax: (423) 783-7970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2153 (TN)

Record details

NPI number1790849081
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedDecember 20, 2006
Last updated in NPPESApril 17, 2018
Mailing address1225 E Weisgarber Rd, Suite 200, Knoxville, TN 37909-2604

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolWEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2004 (22 years in practice)
Group practice Summit Medical Group, Pllc — 636 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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