Summit Express Urgent Care, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

19390 Issued in AL

Legal business name

SUMMIT EXPRESS URGENT CARE, LLC

Practice address

1360 Montgomery Hwy
Suite 124
Vestavia, AL 35216-2749

Phone

(205) 329-4565

NPI assigned

Dec 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. L Nicol Pettway, M.D.

Title

Owner

Phone

(205) 329-4565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1528489259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 KINGS MOUNTAIN RDG",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352422242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 MONTGOMERY HWY",
            "address_2": "SUITE 124",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352162749",
            "telephone_number": "205-329-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT EXPRESS URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A",
        "authorized_official_last_name": "PETTWAY",
        "authorized_official_first_name": "L",
        "authorized_official_middle_name": "NICOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-329-4565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AL",
            "license": "19390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376588095",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Elizabeth Stroud
• Caroline Howard Studdard, MD
• Kakarria Sturdivant
• Emily Sullivan
• Summit Counseling and Wellness, LLC
• Summit LC Eye Care PC
• Summit Smiles Pediatric Dentistry, LLC
• Savanna Sumner
• Tina Marie Sumpter, LPC
• Jonathan Sun, PHARMD

• Clinic/Center in Vestavia, AL
• Providers in Vestavia, AL by specialty
• Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.