NPIMap

Organization Active NPI

Summitridge

  • Psychiatric Hospital
  • Lawrenceville, GA
National Provider Identifier
1134310980
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
SUMMITRIDGE
Practice address
250 Scenic Hwy
Lawrenceville, GA 30045-5675
Phone
(678) 312-3585
Fax
(678) 312-5915
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Mr. Matthew Caudill, LCSW
Title
Assessment CSLR
Phone
(678) 312-5850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

250 Scenic Hwy
Lawrenceville, GA 30045-5675

Mailing address

250 Scenic Hwy
Lawrenceville, GA 30045-5675
Phone (678) 312-3585

National Provider Directory

National Provider Directory
Tax ID family
Gwinnett Medical Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1134310980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SCENIC HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300455675",
            "telephone_number": "678-312-3585",
            "fax_number": "678-312-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SCENIC HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300455675",
            "telephone_number": "678-312-3585",
            "fax_number": "678-312-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMITRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "CAUDILL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ASSESSMENT CSLR",
        "authorized_official_telephone_number": "678-312-5850",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.