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

Staci Owen, PA

Individual provider Physician Assistant · NPI 1477919074

Staci Owen, PA is a Physician Assistant in Maryville, Tennessee. Qualified in 2015, 11 years ago. Practices with Summit Medical Group, PLLC, a 636-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
11
Licensed in
TN
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

701 Morganton Square Dr
Maryville, TN 37801-4796
Phone: (865) 984-6823
Fax: (865) 984-0824
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2948 (TN)

Record details

NPI number1477919074
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 12, 2016
Last updated in NPPESDecember 11, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 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

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