Summit Avenue Pain Center, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

SUMMIT AVENUE PAIN CENTER, LLC

Practice address

1201 Summit Ave
Suite 400
Fort Worth, TX 76102-4413

Phone

(972) 234-4740

Fax

(972) 231-7095

NPI assigned

Oct 18, 2010

Organization subpart

No

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

Authorized official

Name

Ted Grosbeck

Title

Manager

Phone

(469) 362-6909

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1295045854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674210",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SUMMIT AVE",
            "address_2": "SUITE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024413",
            "telephone_number": "972-234-4740",
            "fax_number": "972-231-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT AVENUE PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "GROSBECK",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-362-6909"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Kristin Summerhill, PA-C
• David D. Summers, CRNA
• Hunter Grae Summers
• Kimberly P Summerville, LCSW
• Alexandria E Summey, APRN
• Summit Emergency Medicine, PLLC
• Summit Neuromonitoring LLC
• Summit NP Services, LLC
• Summit Pain & Anesthesia Consultants
• William Bradley Summy, PH.D., L.P.C.

• Pain Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pain Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.