NPIMap

Individual provider Active NPI

William C Summers, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1265471650
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2007010580 Issued in MO
Practice address
3915 Watson Rd Ste 202
Saint Louis, MO 63109-1251
Phone
(314) 244-3818
Fax
(888) 464-1108
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 2007010580 MO
Infectious Disease Physician 207RI0200X 39419 TN
Internal Medicine Physician 207R00000X 2007010580 MO Primary

Addresses

Primary practice location

3915 Watson Rd Ste 202
Saint Louis, MO 63109-1251

Mailing address

3915 Watson Rd Ste 202
Saint Louis, MO 63109-1251
Phone (314) 244-3818

Other practice location 1

6188 MacKenzie Valley Ct
Saint Louis, MO 63123-3477
Phone (314) 686-9714

Other identifiers 6

IdentifierTypeStateIssuer
09016197MedicaidMS
3327876MedicaidTN
4102661OtherTNBCBS OF TN
204589808MedicaidMO
3721649MedicaidTN
09752214MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070724000735 MO Practitioner - Internal MedicinePractitioner - Infectious Disease 0648224329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summers Healthcare LLCGroup PAC ID 5597049536, 2 clinicians

Practice addresses (Care Compare)

3915 Watson Rd
Saint Louis, MO 63109-1251
Phone (314) 267-9316

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39419TNMDPharmacist
2007010580MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Threlkeld Threlkeld and Omer PLLC Infectious Disease PastSince Dec 1, 2018 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJICD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJICD/Endpoint/EDJICD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1265471650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091251",
            "telephone_number": "314-244-3818",
            "fax_number": "888-464-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 WATSON RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091251",
            "telephone_number": "314-244-3818",
            "fax_number": "888-464-1108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6188 MacKenzie Valley Ct",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631233477",
            "country_code": "US",
            "telephone_number": "314-686-9714",
            "fax_number": "888-464-1108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-05-31",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2007010580",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "39419",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007010580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016197",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3327876",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4102661",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204589808",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721649",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09752214",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.