NPIMap

Organization Active NPI

Summa Physicians LLC

Doing business as Summa Health Medical Group

  • Psychiatry Physician
  • Medina, OH
National Provider Identifier
1063750206
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SUMMA PHYSICIANS LLC
Doing business as
Summa Health Medical Group
Practice address
3780 Medina Rd Ste 220
Medina, OH 44256-9312
Phone
(330) 721-7604
Fax
(330) 721-7606
NPI assigned
Jan 23, 2013
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Wendy Carson
Title
Manager, Payer Enrollment
Phone
(234) 312-5691

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Clinical Psychologist 103TC0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

3780 Medina Rd Ste 220
Medina, OH 44256-9312

Mailing address

1077 Gorge Blvd
Akron, OH 44310-2408
Phone (234) 312-5873

Other identifiers 1

IdentifierTypeStateIssuer
0078860MedicaidOH

Other names 1

  • Summa Health Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000295 OH Part B Supplier - Clinic/Group Practice 2961303532 Receives reassigned benefits from 729 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Summa Physicians Inc89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1063750206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GORGE BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102408",
            "telephone_number": "234-312-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 MEDINA RD STE 220",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569312",
            "telephone_number": "330-721-7604",
            "fax_number": "330-721-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMA PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MANAGER, PAYER ENROLLMENT",
        "authorized_official_telephone_number": "234-312-5691"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0078860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summa Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.