NPIMap

Organization Active NPI

Summit Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Casper, WY
National Provider Identifier
1366220501
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
SUMMIT PATHOLOGY
Practice address
1233 E 2ND St
Casper, WY 82601-2926
Phone
(970) 212-0530
NPI assigned
Sep 19, 2023
Last updated
Sep 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Jeff Christinson
Title
Ceo
Phone
(970) 212-0557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

1233 E 2ND St
Casper, WY 82601-2926

Mailing address

5802 Wright Dr
Loveland, CO 80538-8806
Phone (970) 212-0530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150730012393 WY Part B Supplier - Clinic/Group Practice 3971595968 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casper, WY; Cheyenne, WY; Laramie, WY

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2288216Summit Pathology1233 East Second Street, Casper, WY 82601ComplianceNov 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Summit Pathology11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1366220501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 WRIGHT DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388806",
            "telephone_number": "970-212-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012926",
            "telephone_number": "970-212-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "CHRISTINSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-212-0557"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.