NPIMap

Organization Active NPI

Summit Rehabilitation LLC

  • Pulmonary Disease Physician
  • Avon, OH
National Provider Identifier
1295402923
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SUMMIT REHABILITATION LLC
Practice address
33355 Health Campus Blvd
Avon, OH 44011-1399
Phone
(330) 670-0460
NPI assigned
Aug 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Authorized official

Name
Dr. Harish Kakarala, MDNPI 1265442776
Title
Founder/Ceo
Phone
(216) 401-3850

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

33355 Health Campus Blvd
Avon, OH 44011-1399

Mailing address

3588 N Shore Dr
Akron, OH 44333-8331
Phone (330) 670-0460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211020002559 OH Part B Supplier - Clinic/Group Practice 1557759776 Receives reassigned benefits from 6 practitioners
Practice locations: Avon, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1295402923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3588 N SHORE DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338331",
            "telephone_number": "330-670-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33355 HEALTH CAMPUS BLVD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111399",
            "telephone_number": "330-670-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "KAKARALA",
        "authorized_official_first_name": "HARISH",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "216-401-3850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.

Verify at the official NPI Registry.