Organization Active NPI

Summa Physicians LLC

Doing business as Summa Health Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Uniontown, OH
National Provider Identifier
1104088921
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
SUMMA PHYSICIANS LLC
Doing business as
Summa Health Medical Group
Practice address
1790 Graybill Rd Ste 200
Uniontown, OH 44685-7993
Phone
(234) 312-2111
Fax
(330) 634-9558
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 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
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

1790 Graybill Rd Ste 200
Uniontown, OH 44685-7993

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2868722MedicaidOH

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

Locations

87 Conservatory Dr
Ste A
Barberton, OH 44203
Phone (330) 753-3500

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1104088921",
    "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": "1790 GRAYBILL RD STE 200",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857993",
            "telephone_number": "234-312-2111",
            "fax_number": "330-634-9558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMA PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "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": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2868722",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summa Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Uniontown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.