Summit Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200101484 Issued in NC

Legal business name

SUMMIT FAMILY MEDICINE

Practice address

515 W Salisbury St
Suite D
Asheboro, NC 27203-5497

Phone

(336) 636-5100

Fax

(336) 636-5144

NPI assigned

Nov 16, 2007

Last updated

Nov 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela A Penner, MDNPI 1679550040

Title

Owner

Phone

(336) 636-5100

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: kate-hoyt@summit-family.e-mdsdirect.com
• Direct secure messaging: pamela-penner@summit-family.e-mdsdirect.com

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pamela A Penner, MD

  • Family Medicine Physician
  • Asheboro, NC
  • NPI 1679550040
  Medicare reassignment NPD Authorized official
• Anna Smith Potts, NP

  • Family Nurse Practitioner
  • Asheboro, NC
  • NPI 1326526328
  Medicare reassignment
• Jessica Nicole Wilburn, NP-C

  • Family Nurse Practitioner
  • Asheboro, NC
  • NPI 1225591118
  NPD

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1316128580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5086",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272045086",
            "telephone_number": "336-636-5100",
            "fax_number": "336-636-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W SALISBURY ST",
            "address_2": "SUITE D",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035497",
            "telephone_number": "336-636-5100",
            "fax_number": "336-636-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "PENNER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-636-5100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200101484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89130T5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "130T5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francis R Stolfo, LPA
• Shanna Dawne Stowe, FNP
• Christopher Michael Street, MD
• Eric Streich, LAT, ATC
• Abaigeal Jeanne Styring
• Sunbridge Regency - North Carolina, Inc. (Woodland Hill Care and Rehabilitation Center)
• Michael Swartz, AGNP-C
• Ava M Swayze, DO
• Julius Mboni Tah, PHARMD
• McCall Sink Tanner, D.C

• Family Medicine Physician in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.