Summit Sleep Disorder Center, PA

Primary specialty

Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X

License

19652 Issued in NC

Legal business name

SUMMIT SLEEP DISORDER CENTER, PA

Practice address

160 Charlois Blvd
Winston Salem, NC 27103-1522

Phone

(336) 768-5834

Fax

(336) 765-4889

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Patricia C Pulliam

Title

Vice President Administration

Phone

(336) 768-5834

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1205968963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-5834",
            "fax_number": "336-765-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-768-5834",
            "fax_number": "336-765-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SLEEP DISORDER CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT ADMINISTRATION",
        "authorized_official_telephone_number": "336-768-5834"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "19652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "210527C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSOFNC",
            "identifier": "01151",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901151",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilfred Gerald Summers Jr.
• Summit Eye Care Surgery Center, PLLC
• Summit Eye Care, P.a.
• Summit Eye Care, PA
• Summit Sleep Disorder Center, PA
• Summit Sleep Disorder Center, PA
• Summit Sleep Disorder Center, PA
• Jennifer Andrews Sumner, M.D.
• Lindsey Smith Sumner, MS
• Thomas Edward Sumner, MD

• Sleep Medicine (Psychiatry & Neurology) Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Sleep Medicine (Psychiatry & Neurology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.