Active NPI
Summit Medical Carolinas LLC
- Family Medicine Physician
- Fort Mill, SC
National Provider Identifier
1285343871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SUMMIT MEDICAL CAROLINAS LLC
- Practice address
- 885 Gold Hill Rd # 253
Fort Mill, SC 29708-7946 - Phone
- (720) 644-9355
- NPI assigned
- Nov 22, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rajendra Kadari, M.D.
- Title
- Member/Manager
- Phone
- (720) 644-9355
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X |
Addresses
Primary practice location
885 Gold Hill Rd # 253
Fort Mill, SC 29708-7946
Mailing address
9250 E Costilla Ave Ste 540
Greenwood Village, CO 80112-3648
Phone (720) 644-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
9250 E Costilla Ave
Ste 540
Greenwood Village, CO 80112
8430 Rea Rd
Ste E
Charlotte, NC 28277
Phone (980) 443-6788
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Columbia, SC
- NPI 1881101442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712102400000",
"number": "1285343871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9250 E COSTILLA AVE STE 540",
"city": "GREENWOOD VILLAGE",
"state": "CO",
"postal_code": "801123648",
"telephone_number": "720-644-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "885 GOLD HILL RD # 253",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297087946",
"telephone_number": "720-644-9355"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMIT MEDICAL CAROLINAS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-22",
"last_updated": "2024-04-03",
"certification_date": "2024-04-03",
"status": "A",
"authorized_official_last_name": "KADARI",
"authorized_official_first_name": "RAJENDRA",
"authorized_official_title_or_position": "MEMBER/MANAGER",
"authorized_official_telephone_number": "720-644-9355",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.