NPIMap

Organization Active NPI

Summit Cosmetic Surgery Center

  • Specialist
  • Wilmington, NC
National Provider Identifier
1346607066
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9600699 Issued in NC
Legal business name
SUMMIT COSMETIC SURGERY CENTER
Practice address
1717 Shipyard Blvd
Suite 100
Wilmington, NC 28403-8023
Phone
(910) 794-5355
Fax
(910) 794-5358
NPI assigned
Jan 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Tom Norin
Title
Practice Administrator
Phone
(910) 794-5355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9600699 NC Primary

Addresses

Primary practice location

1717 Shipyard Blvd
Suite 100
Wilmington, NC 28403-8023

Mailing address

1717 Shipyard Blvd
Suite 100
Wilmington, NC 28403-8023
Phone (910) 794-5355

Other identifiers 3

IdentifierTypeStateIssuer
CH0945OtherNCRAILROAD MEDICARE PTAN
2344578OtherNCPTAN
89016GKMedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1346607066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038023",
            "telephone_number": "910-794-5355",
            "fax_number": "910-794-5358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 100",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038023",
            "telephone_number": "910-794-5355",
            "fax_number": "910-794-5358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COSMETIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "NORIN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-794-5355"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "9600699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "CH0945",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2344578",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016GK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.