Lewis Tyler Sumner, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3483 Issued in SC

Practice address

1209 Ella St
Anderson, SC 29621-4811

Phone

(864) 226-7503

Fax

(864) 225-4937

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 12, 2023 through Oct 12, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1225011323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 ELLA ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214811",
            "telephone_number": "864-226-7503",
            "fax_number": "864-225-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 ELLA ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214811",
            "telephone_number": "864-226-7503",
            "fax_number": "864-225-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "LEWIS",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "3483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3483",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiara Sullivan
• Thomas James Sullivan Jr., MD
• Kevin Matthew Summers, D.O.
• Summit Home Health Care Inc.
• Summit Home Health Care, Inc
• Ja'Pel Sumpter
• Thomas John Sunshine, MD
• Superior Pain Management PC
• Superior Wellness
• Satish K Surabhi, MD

• Oral and Maxillofacial Surgery (Dentist) in Anderson, SC
• Providers in Anderson, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.