Summit Cardiovascular Group LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUMMIT CARDIOVASCULAR GROUP LLC

Practice address

8854 W Emerald St Ste 260
Boise, ID 83704-4860

Phone

(615) 423-1159

NPI assigned

Dec 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenny Bloebaum

Title

Vice President, Operational Integra

Phone

(615) 423-1159

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1063123578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8854 W EMERALD ST STE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8854 W EMERALD ST STE 260",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044860",
            "telephone_number": "615-423-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CARDIOVASCULAR GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "BLOEBAUM",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "VICE PRESIDENT, OPERATIONAL INTEGRA",
        "authorized_official_telephone_number": "615-423-1159"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.