NPIMap

Organization Active NPI

Summit Medical Group, Inc

  • Urgent Care Clinic/Center
  • Florence, KY
National Provider Identifier
1174096580
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SUMMIT MEDICAL GROUP, INC
Practice address
8726 US Highway 42
Florence, KY 41042-8550
Phone
(859) 647-2900
Fax
(859) 647-0140
NPI assigned
Jan 8, 2019
Organization subpart
Yes
Parent organization
SUMMT MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Authorized official

Name
Maria Rankin
Title
Avp - Revenue Cycle
Phone
(859) 655-2583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

8726 US Highway 42
Florence, KY 41042-8550

Mailing address

1360 Dolwick Drive
Erlanger, KY 41018
Phone (859) 344-5555

Other names 1

  • St. Elizabeth Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190424002624 KY DME Supplier - Physician - General Practice 2163326240 Practice locations: Florence, KY

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0324417St Elizabeth Physicians8726 US 42, Florence, KY 41042Provider-performed microscopyJul 15, 2028
18D2042236St Elizabeth Physicians Urgent Care8726 US Highway 42, Florence, KY 41042Certificate of waiverJun 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Groupinc18 organizations share this tax ID, including this one
Part of
Summit Medical Groupinc

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1174096580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 DOLWICK DRIVE",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "41018",
            "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": "8726 US HIGHWAY 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410428550",
            "telephone_number": "859-647-2900",
            "fax_number": "859-647-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMT MEDICAL GROUP, INC",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "AVP - REVENUE CYCLE",
        "authorized_official_telephone_number": "859-655-2583"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.