Summit Springs Wellness Center LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SUMMIT SPRINGS WELLNESS CENTER LLC

Practice address

6161 Busch Blvd Ste 200-201
Columbus, OH 43229-2508

Phone

(614) 468-1222

Fax

(614) 468-1255

NPI assigned

Sep 13, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Renee Xu

Title

Owner

Phone

(614) 822-9293

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Summit Springs Wellness Center LLC

  • Adult Mental Health Clinic/Center
  • Columbus, OH
  • NPI 1811774623

  O20240325003059

  Same enrollment

Tax ID family

Summit Springs Wellness Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Summit Springs Wellness Center LLC

  • Adult Mental Health Clinic/Center
  • Columbus, OH
  • NPI 1811774623
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bryan David Borland, DO

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Columbus, OH
  • NPI 1457643637
  Medicare reassignment NPD
• Robert J Oaks, LPCC-S

  • Counselor
  • Columbus, OH
  • NPI 1811155617

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Lee Burge, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1528509296
  NPD

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1225815285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 BUSCH BLVD STE 200-201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292508",
            "telephone_number": "380-203-2886",
            "fax_number": "380-203-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 BUSCH BLVD STE 200-201",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292508",
            "telephone_number": "614-468-1222",
            "fax_number": "614-468-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SPRINGS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-822-9293",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0032196",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Summers, CPNP-AC
• Summerville at Chestnut Hill, LLC
• Enegue Summerville
• Summit Academy Transition High School - Columbus
• Summit Senior Daycare LLC
• Summit Springs Wellness Center LLC
• Summitacademycommunityschoolscolumbus
• Summitacademymiddleschoolcolumbus
• Sun Behavioral Columbus, LLC
• Sun Rise Agency LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Columbus, OH
• Providers in Columbus, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.