NPIMap

Organization Active NPI

Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
National Provider Identifier
1356574560
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
SUMMIT MEDICAL CENTER
Practice address
1800 S. Renaissance Blvd.
Edmond, OK 73013-3023
Phone
(405) 359-2400
Fax
(405) 359-9186
NPI assigned
Sep 3, 2009
Last updated
Aug 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Mr. Douglas G. Baker
Title
Executive Vice President
Phone
(405) 359-2460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
General Acute Care Hospital 282N00000X OK Primary

Addresses

Primary practice location

1800 S. Renaissance Blvd.
Edmond, OK 73013-3023

Mailing address

P.O. Box 269083
Oklahoma City, OK 73126
Phone (405) 359-2400

Other names 1

  • Summit Medical Center, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091013000626 OK Part A Provider - Hospital 9436295946 Practice locations: Edmond, OK; Oklahoma City, OK

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1356574560. Details of each certification follow.

Hospital certification: CCN 370225

Legal name
SUMMIT MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
May 24, 2006
Last certification
Jan 7, 2021
Beds
15
Ownership / control type
Physician ownership
Most recent change of ownership
Mar 22, 2010 (1 total)
Organization structure
LLCProprietary
Incorporated
Aug 28, 2009 in OK
Enrollment address
1800 Renaissance Blvd
FL 1
Edmond, OK 73013-3023
Main/Primary Hospital Location
Hospital subgroups
General

Hospital certification: CCN 370196

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RENAISSANCE WOMENS CENTER OF EDMOND
Certification status
Terminated Voluntary: merger or closure, Oct 1, 2005
Provider type (POS)
Hospital – Short-term
Participating since
Mar 26, 1996
Last certification
Mar 26, 1996
Beds
14
Ownership / control type
Private (for profit)
Facility address
1800 South Renaissance Boulevard
Edmond, OK 73013

Care Compare: Hospital

Medicare Care Compare
Listed as
Summit Medical Center, LLCCCN 370225 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Center Laboratory2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations (25 of 397)

300 Twining St
Montgomery, AL 36112
Phone (334) 953-5143

412 SE 11TH St
Anadarko, ANADARKO 73005

30 Northridge Dr
Van Buren, AR 72956
Phone (479) 922-9355

2222 E Highland Ave
Ste 320
Phoenix, AZ 85016
Phone (602) 956-9360

2200 Santa Monica Blvd
Ste 13
Santa Monica, CA 90404

1007 Medical Park Blvd
Edmond, EDMOND 73013

1009 S Bryant Ave
Edmond, EDMOND 73034

3800 S Blvd
Edmond, EDMOND 73013

301 Turner St
Clearwater, FL 33756
Phone (727) 466-6789

755 Scott Cir
Joint Base Pearl Hbr Hickam, HI 96853
Phone (808) 448-6100

1905 19th St
Great Bend, KS 67530
Phone (620) 792-5700

1001 N Minneapolis St
Wichita, KS 67214
Phone (316) 293-1840

14700 W Saint Teresa St
Ste 210
Wichita, KS 67235
Phone (316) 274-9455

1710 S Broadway St Ste a
Marlow, MARLOW 73055

332 S Main Ave
Republic, MO 65738
Phone (417) 432-5058

500 Fisher St
Keesler AFB, MS 39534
Phone (228) 376-0444

1001 N Country Club Rd
Ada, OK 74820
Phone (580) 421-4570

1414 Arlington St
#150
Ada, OK 74820

1921 Stonecipher Dr
Ste A
Ada, OK 74820

201 N Monte Vista St
Ste B
Ada, OK 74820
Phone (580) 436-4200

905 Colony Dr
Bldg B
Ada, OK 74820

905 Colony Dr
Ste B
Ada, OK 74820

301 N 1st St
#46
Altus, OK 73523
Phone (580) 481-5290

400 4th St
Alva, OK 73717

1013 15th Ave NW
Ardmore, OK 73401
Phone (580) 226-4544

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey J Smith Individual 5% Or Greater Direct Ownership Interest Jan 1, 2015 8.6%
Sandeep N Shah Individual 5% Or Greater Direct Ownership Interest Jan 1, 2015 5.21%
Douglas Baker Individual Corporate OfficerExecutive Vice President Nov 2, 2009
W-2 Managing EmployeeExecutive Vice President Mar 22, 2010
Toby D Broussard Individual 5% Or Greater Direct Ownership Interest Jan 1, 2015 5.48%
Gregory F Walton Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2015 8.6%
Tammy L Lindsey Individual Corporate OfficerCoo/Cno Nov 1, 2011
W-2 Managing EmployeeCoo/Cno Nov 1, 2012
Solara Summit Partners LLC Organization, Southlake, TX LLC, Management services company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2015 20%
Curtis Summers Individual Corporate OfficerCeo Dec 16, 2003
W-2 Managing EmployeeCeo Mar 22, 2010

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3,343

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.

View all 3,343

Affiliated clinicians 72

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1356574560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 269083",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73126",
            "telephone_number": "405-359-2400",
            "fax_number": "405-359-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S. RENAISSANCE BLVD.",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133023",
            "telephone_number": "405-359-2400",
            "fax_number": "405-359-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "405-359-2460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Medical Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Summit Medical Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.