Active NPI
Katina Marie Summerford, MD
- Pediatrics Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 60607
- Practice address
- 1919 E Thomas Rd
Phoenix, AZ 85016-7710 - Phone
- (602) 933-1900
- NPI assigned
- Apr 30, 2017
- Last updated
- Feb 1, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R76104 | AZ | |
| Pediatrics Physician | 208000000X | 60607 | AZ | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082762 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R76104 | AZ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital | Pediatric Emergency Medicine | Current | Accepting new patients |
| WJH Physician Services | Family Medicine | Current | Accepting new patients |
| Children's Hospital | Current | Accepting new patients | |
| Childrens Hospital Medical Practice Corporation | Pediatrics | Current | Accepting new patients |
| Phoenix Children's Hospital | Pediatrics | Current | Accepting new patients |
Locations
1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777
3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814
141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337
1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511
1111 Medical Center Blvd
Ste S250
Marrero, LA 70072
Phone (504) 347-5511
3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880
4545 Veterans Memorial Blvd
Metairie, LA 70006
Phone (504) 896-9822
200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Manning Family Children's
- Specialist
- New Orleans, LA
- NPI 1043230873
Pediatric Emergency Medicine
-
- Pediatrics Physician
- New Orleans, LA
- NPI 1821090713
-
dba Phoenix Children's Medical Group
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- New Orleans, LA
- NPI 1568597649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1275068090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 E CAMELBACK RD STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182327",
"telephone_number": "602-933-1815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERFORD",
"first_name": "KATINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-30",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "R76104",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "60607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "082762",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
- Sumir Mathur, DMD, PLC (Aspen Dental)
- Tamara Neshae Sumler, NP
- Summer Breeze Health LLC
- Summer Skys Group Home LLC (Summer Skys Group Home)
- Barry Summer, MD
- Summerhaven Assisted Living Home LLC
- Jancarlo Jair Summers-Hernandez, PTA, CSCS
- Christina Summers, FNP-C
- Claudia Anne Summers, PSY. D.
- Deborah K Summers, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.