NPIMap

Organization Active NPI

Summit Pathology

  • Clinical Medical Laboratory
  • Loveland, CO
National Provider Identifier
1396971123
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLIA 06D1024422 Issued in CO
Legal business name
SUMMIT PATHOLOGY
Practice address
5802 Wright Dr
Loveland, CO 80538-8806
Phone
(800) 920-6227
Fax
(970) 353-5614
NPI assigned
Jun 8, 2009
Last updated
Dec 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Dr. H Wentzell Hamner, MD
Title
Managing Partner
Phone
(970) 461-6091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLIA 06D1024422 CO Primary

Addresses

Primary practice location

5802 Wright Dr
Loveland, CO 80538-8806

Mailing address

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

Other names 1

  • Greeley Pathologists LLP dba Summit Pathology Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080313000662 CO Part B Supplier - Independent Clinical Laboratory 3971595968 Receives reassigned benefits from 1 practitioner
Practice locations: Loveland, CO

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
06D1024422Summit Pathology Laboratories, Inc5802 Wright Dr, Loveland, CO 80538AccreditationJul 30, 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.

Locations

2555 E 13th St
Ste 120
Loveland, CO 80537
Phone (970) 330-5824

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1396971123",
    "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",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 WRIGHT DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388806",
            "telephone_number": "800-920-6227",
            "fax_number": "970-353-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "HAMNER",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "WENTZELL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "970-461-6091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CO",
            "license": "CLIA 06D1024422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greeley Pathologists LLP dba Summit Pathology",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Greeley Pathologists LLP dba Summit Pathology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.