NPIMap

Organization Active NPI

Summit Medical Group, Inc.

Doing business as St. Elizabeth Physicians

  • Rural Health Clinic/Center
  • Vevay, IN
National Provider Identifier
1215770375
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SUMMIT MEDICAL GROUP, INC.
Doing business as
St. Elizabeth Physicians
Practice address
1035 West Main Street
Vevay, IN 47043-9126
Phone
(812) 496-8786
NPI assigned
Jun 17, 2024
Last updated
Jun 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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) 344-5555

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Sports Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080S0010X
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0500X
Rural Health Clinic/Center 261QR1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1035 West Main Street
Vevay, IN 47043-9126

Mailing address

1360 Dolwick Drive
Erlanger, KY 41018-3127
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 IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040403000151 IN Part B Supplier - Clinic/Group Practice 2163326240 Receives reassigned benefits from 250 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrenceburg, IN; Aurora, IN; Vevay, IN; Rising Sun, IN; Milan, IN; Greendale, IN; Batesville, IN
O20240823000385 IN Part A Provider - Rural Health Clinic 2163326240 Practice locations: Vevay, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215770375. Details of each certification follow.

Rural health clinic certification: CCN 153959

Legal name
SUMMIT MEDICAL GROUP INC
Doing business as
ST. ELIZABETH PHYSICIANS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 26, 2025
Last certification
Feb 26, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1035 W Main St
Vevay, IN 47043-9126

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
15D2169451St Elizabeth Physicians1035 W Main Street Suite 1, Vevay, IN 47043Certificate of waiverJul 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Group18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

1360 Dolwick Dr
Erlanger, KY 41018
Phone (800) 737-7900

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Heidi C Murley Individual Corporate OfficerCeo Jan 1, 2022
W-2 Managing Employee Jan 1, 2022
Donald L Price Individual Corporate DirectorBoard Member Jan 1, 2019
Christopher Myrtil Individual Corporate DirectorBoard Member Jan 1, 2026
Maria Rankin Individual W-2 Managing EmployeeAvp of Revenue Cycle Services Jan 1, 2024
Linda M Hermiller Individual Corporate DirectorBoard Member Jan 1, 2022
Chaitanya Mandapakala Individual Corporate DirectorBoard Member Jan 1, 2019
Sonia R Chopra Individual Corporate DirectorBoard Member Jan 1, 2020
Lori a Ritchey-Baldwin Individual Corporate DirectorBoard Member Jan 1, 2017
Bradley S Patterson Individual Corporate DirectorBoard Member Jan 1, 2024
Joseph E Martin Individual Corporate Director Jan 1, 2025
Kevin M Schuler Individual Corporate DirectorBoard Member Jan 1, 2026
Thom Andrew Bunnell Individual Corporate DirectorBoard Member Jan 1, 2021
Yancey R. Holmes Individual Corporate DirectorBoard Member Jan 1, 2026
Lisa a Arehart Individual Corporate DirectorBoard Member Jan 1, 2019
Vicki C Chan Individual Corporate DirectorBoard Member Jan 1, 2023
Garren Colvin Individual Corporate DirectorBoard Member Jan 1, 2017
John C Peterson Individual Corporate DirectorBoard Member Jan 1, 2025
Patricia a Abello Individual Corporate Director Jan 1, 2025

Owners & managing parties with NPI records 15

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 15

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1215770375",
    "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": "410183127",
            "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": "1035 WEST MAIN STREET",
            "city": "VEVAY",
            "state": "IN",
            "postal_code": "470439126",
            "telephone_number": "812-496-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "AVP- REVENUE CYCLE",
        "authorized_official_telephone_number": "859-344-5555"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vevay, IN

Sources for this page

Verify at the official NPI Registry.