NPIMap

Individual provider Active NPI

Taylor Mackenzie Summers, PA-C

  • Plastic Surgery Physician
  • Charleston, WV
National Provider Identifier
1093316184
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
2931 Issued in WV
Practice address
210 Brooks St Ste 200
Charleston, WV 25301-1848
Phone
(304) 388-1930
NPI assigned
Nov 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 2931 WV Primary

Addresses

Primary practice location

210 Brooks St Ste 200
Charleston, WV 25301-1848

Mailing address

111 Summit Dr
Morehead, KY 40351-9706
Phone (606) 207-4872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201205000106 WV Practitioner - Physician Assistant 9931510419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Hospital Dr
Hurricane, WV 25526-9202
Phone (304) 757-1700

210 Brooks St
Suite 200
Charleston, WV 25301-1848
Phone (304) 388-1930

3948 Teays Valley Rd
Hurricane, WV 25526-8728

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Oct 9, 2020 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Oct 9, 2020 Accepting new patients

Locations

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

210 Brooks St
Ste 200
Charleston, WV 25301
Phone (304) 388-1930

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1093316184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SUMMIT DR",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403519706",
            "telephone_number": "606-207-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BROOKS ST STE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011848",
            "telephone_number": "304-388-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "TAYLOR",
        "middle_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WV",
            "license": "2931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.