NPIMap

Organization Active NPI

Summit Medical Group, LLC

  • Internal Medicine Physician
  • Milwaukie, OR
National Provider Identifier
1235344060
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17146 Issued in OR
Legal business name
SUMMIT MEDICAL GROUP, LLC
Practice address
12633 SE Oatfield Rd
Milwaukie, OR 97222-6939
Phone
(503) 307-1422
NPI assigned
May 14, 2007
Last updated
Oct 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Authorized official

Name
Dr. Judith A Lindsey, MD
Title
Physician and Surgeon
Phone
(503) 307-1422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17146 OR Primary

Addresses

Primary practice location

12633 SE Oatfield Rd
Milwaukie, OR 97222-6939

Mailing address

PO Box 22165
Milwaukie, OR 97269-2165
Phone (503) 307-1422

Other identifiers 5

IdentifierTypeStateIssuer
1235344060OtherORMEDICARE NPI
1932162880OtherORMEDICARE NPI
715535-81OtherOROREGON STATE BUSINESS LIC
287403MedicaidOR
1922074160OtherORMEDICARE NPI

National Provider Directory

National Provider Directory

Locations

2305 SE Washington St
Ste 105
Portland, OR 97222
Phone (503) 305-8825

Practitioners & affiliated clinicians

Practitioners 6

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": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1235344060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22165",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692165",
            "telephone_number": "503-307-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12633 SE OATFIELD RD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226939",
            "telephone_number": "503-307-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN AND SURGEON",
        "authorized_official_telephone_number": "503-307-1422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "17146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1235344060",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1932162880",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BUSINESS LIC",
            "identifier": "715535-81",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287403",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1922074160",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.