Summer Grace Balman
Individual provider Active NPI Physician Assistant · Caldwell, KS
NPI 1033890405 · NPPES record last updated Aug 25, 2025
Key facts
- NPI
- 1033890405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 761 W 175TH St S
Caldwell, KS 67022-8301 - Phone
- (620) 845-2516
- NPI assigned
- Jul 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 25
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Lincoln Memorial University Medical Department, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tift Regional Health System Inc
Sumner County Hospital District No 1
Practice addresses (Care Compare)
150 MJ Taylor Rd
Adel, GA 31620-3497
Phone (229) 896-8440
172 MJ Taylor Rd
Adel, GA 31620-3497
Phone (229) 896-8500
2225 US Hwy 41 N
Tifton, GA 31794-2749
Phone (229) 391-4100
2227 US Hwy 41 N
Tifton, GA 31794-2749
Phone (229) 353-6188
761 W 175TH St S
Caldwell, KS 67022-8301
Phone (620) 845-6492
Hospital & facility affiliations
- Caldwell Regional Medical Center
- Tift Regional Medical Center
- SCK Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240227003150 | GA | Practitioner - Physician Assistant | 0042655219 | Reassigns benefits to 3 organizations |
| I20250520000874 | KS | Practitioner - Physician Assistant | 0042655219 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11960 | GA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sumner County Hospital District No 1 | Current |
Accepting new patients | |
| Lindsborg Community Hospital Association | Current |
Accepting new patients | |
| Urgent Care of Oconee, LLC | Current |
Accepting new patients | |
| Sumner County Hospital District No 1 | Current |
Accepting new patients | |
| Lindsborg Community Rural Health Clinic Inc | Current | Accepting new patients | |
| Lindsborg Community Hospital Association | Current |
Accepting new patients | |
| Urgent Care of Oconee, LLC | Current |
Accepting new patients | |
| Tift Regional Health System Inc | Current | Accepting new patients | |
| Lindsborg Community Hospital Association | Current | Accepting new patients | |
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| Fort Oglethorpe Emergency Physicians Group LLC | Current |
Accepting new patients |
Locations
2375 W Broad St
Ste G
Athens, GA 30606
Phone (706) 567-6151
2855 Old Highway 5
Blue Ridge, GA 30513
Phone (706) 632-4263
1690 Eatonton Rd
Madison, GA 30650
Phone (706) 342-7272
901 18th St E
Tifton, GA 31794
Phone (229) 353-6208
2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422
2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188
2061 Experiment Station Rd
Ste 505
Watkinsville, GA 30677
Phone (706) 310-0324
761 W 175th St S
Caldwell, KS 67022
Phone (620) 845-6492
605 W Lincoln St
Lindsborg, KS 67456
Phone (785) 227-3308
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HDIEDD/Endpoint/HDIEDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
761 W 175TH St S
Caldwell, KS 67022-8301
Mailing address
761 W 175TH St S
Caldwell, KS 67022-8301
Phone (620) 845-2516
Other providers in Caldwell, KS
- Jim D Blunk
- Karissa Bratcher
- Caldwell Compounding Pharmacy Inc
- Caldwell Pharmacy Inc
- Caldwell Pharmacy Inc
All providers in Caldwell, KS · Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.