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
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 identifiers 1

IdentifierTypeStateIssuer
37D1049908OtherOKCLIA ID

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

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

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

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical Center2 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 392)

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) 420-4575

2310 E Brown Rd
Mesa, AZ 85213
Phone (480) 649-9000

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

234 S 1st Ave
Ste 101
Arcadia, CA 91006
Phone (626) 447-7008

2200 Santa Monica Blvd
Ste 13
Santa Monica, CA 90404

3800 S Blvd
Edmond, EDMOND 73013

1007 Medical Park Blvd
Edmond, EDMOND 73013

1009 S Bryant Ave
Edmond, EDMOND 73034

307 Boatner Rd
Ste 114
Eglin AFB, FL 32542
Phone (850) 883-8132

19495 Biscayne Blvd
Ste 200
Miami, FL 33180
Phone (305) 932-5557

612 N Andover Rd
Andover, KS 67002
Phone (316) 613-4976

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

1710 S Broadway St Ste a
Marlow, MARLOW 73055

250 Thompson St
Saint Paul, MN 55102
Phone (651) 297-6504

33 Gage Dr
Hollister, MO 65672
Phone (417) 334-8300

500 Fisher St
Keesler AFB, MS 39534
Phone (228) 376-0481

1414 Arlington St
#150
Ada, OK 74820

905 Colony Dr
Ste B
Ada, OK 74820

1705 Cradduck Rd
Ada, OK 74820
Phone (580) 279-6313

905 Colony Dr
Bldg B
Ada, OK 74820

530 N Monte Vista St
Ste A
Ada, OK 74820
Phone (580) 310-9510

1921 Stonecipher Dr
Ste A
Ada, OK 74820

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

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 3,343

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

View all 3,343

Affiliated clinicians 72

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

View all 72

Care Compare: Hospital

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

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID",
            "identifier": "37D1049908",
            "state": "OK"
        }
    ],
    "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.