Organization Active NPI

Summers Pharmacy of Kearney, Corp.

Doing business as Summers Pharmacy

  • Community/Retail Pharmacy
  • Kearney, MO
National Provider Identifier
1447877055
Registry record updated Oct 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SUMMERS PHARMACY OF KEARNEY, CORP.
Doing business as
Summers Pharmacy
Practice address
101 W 92 Hwy Ste a
Kearney, MO 64060-7591
Phone
(816) 635-7005
Fax
(816) 635-7007
NPI assigned
Jun 30, 2020
Last updated
Oct 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2021

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

Authorized official

Name
Ryan Summers
Title
President/Owner
Phone
(816) 635-7005

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

101 W 92 Hwy Ste a
Kearney, MO 64060-7591

Mailing address

605 Pawnee St
Clinton, MO 64735-2757
Phone (660) 383-1910

Other identifiers 1

IdentifierTypeStateIssuer
6000086844MedicaidMO

Other names 1

  • Summers Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200915000626 MO Part B Supplier - Mass Immunization (Roster Biller Only) 5890113419 Practice locations: Kearney, MO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634428800000",
    "number": "1447877055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 PAWNEE ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352757",
            "telephone_number": "660-383-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 92 HWY STE A",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640607591",
            "telephone_number": "816-635-7005",
            "fax_number": "816-635-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERS PHARMACY OF KEARNEY, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "816-635-7005"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000086844",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kearney, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.