Shane O Summers, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9401061 Issued in NC

Practice address

221 13TH Avenue PL NW
Ste 202
Hickory, NC 28601-2596

Phone

(828) 322-8484

Fax

(828) 324-9526

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Ohio State University College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gentiva Health Services Home health agency, Hickory, NC, CCN 347300
• Guardian Home Health Home health agency, Hickory, NC, CCN 347085
• Carolina Caring Hospice, Newton, NC, CCN 341535
• Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143
• Frye Regional Medical Center Hospital, Hickory, NC, CCN 340116

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 35)

Interoperability endpoints

• Direct secure messaging: shane.summers@cvmg.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catawba Valley Medical Group, Inc

  • Family Medicine Physician
  • Catawba, NC
  • NPI 1790062362
  Medicare reassignment Care Compare group NPD
• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1215932215
  Medicare reassignment NPD
• Catawba Valley Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Hickory, NC
  • NPI 1659267359
  NPD
• Catawba Valley Medical Group, Inc

  • Family Medicine Physician
  • Maiden, NC
  • NPI 1124305792
  NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD
• Catawba Valley Medical Group, Inc

  • Family Medicine Physician
  • Sherrills Ford, NC
  • NPI 1326325994
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carolina Caring, Inc.

  • Community Based Hospice Care Agency
  • Newton, NC
  • NPI 1801893151
  Care Compare affiliation
• Catawba Valley Medical Center

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1164495255
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Hickory, NC
  • NPI 1316974272
  Care Compare affiliation
• DLP Frye Regional Medical Center LLC

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1801823349
  Care Compare affiliation
• North Carolina in-Home Partner-IX, LLC

  • Home Health Agency
  • Hickory, NC
  • NPI 1487132866
  Care Compare affiliation

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1497751671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "address_2": "STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012596",
            "telephone_number": "828-322-8484",
            "fax_number": "828-324-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "address_2": "STE 202",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012596",
            "telephone_number": "828-322-8484",
            "fax_number": "828-324-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "SHANE",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9401061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7980873",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian David Sullivan, DO
• Justin L Sullivan, D.O.
• Lindsay Nicole Sullivan, PHARMD
• Kenneth V Summer, M.D.
• Valarie Crisp Summerow, MSN, ANPBC
• Summit Medical Carolinas PLLC
• Sumter Al Holdings
• Support Incorporated
• Support Incorporated
• Support Incorporated

• Family Medicine Physician in Hickory, NC
• Providers in Hickory, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.