Summit Medical Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SUMMIT MEDICAL GROUP, INC

Doing business as

St. Elizabeth Physicians

Practice address

2091 N Bend Rd
Hebron, KY 41048-9691

Phone

(859) 586-2200

Fax

(859) 856-4222

NPI assigned

Dec 16, 2013

Last updated

Dec 16, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glenn Loomis

Title

President/Ceo

Phone

(859) 344-3733

Specialties & licenses 4

Addresses

Other names 1

• St. Elizabeth Physicians Doing business as

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1083035299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHAMBER CENTER DR",
            "address_2": "SUITE 200",
            "city": "LAKESIDE PARK",
            "state": "KY",
            "postal_code": "410171673",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 N BEND RD",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410489691",
            "telephone_number": "859-586-2200",
            "fax_number": "859-856-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "LOOMIS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "859-344-3733"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Hebron, KY
• Providers in Hebron, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.