Summit Services & Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SUMMIT SERVICES & SUPPLIES LLC

Practice address

806 Pine Ave
Kemmerer, WY 83101-2900

Phone

(307) 877-2993

NPI assigned

Feb 8, 2021

Last updated

Oct 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Madonna Em LongNPI 1023600723

Title

Ceo

Phone

(307) 877-2993

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 1

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.

• Madonna Elizabeth Marie Long

  • Durable Medical Equipment & Medical Supplies
  • Kemmerer, WY
  • NPI 1023600723
  NPD Authorized official

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1568054872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1074",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831011074",
            "telephone_number": "307-877-2993",
            "fax_number": "307-316-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 PINE AVE",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831012900",
            "telephone_number": "307-877-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SERVICES & SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MADONNA",
        "authorized_official_middle_name": "EM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-877-2993",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7911390001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2110ILGVF",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Lincoln Hospital District (South Lincoln Medical Specialty Clinic)
• South Lincoln Hospital District (South Lincoln Medical Center)
• South Lincoln Hospital District (Kemmerer Pharmacy)
• South Lincoln Hospital District (South Lincoln Medical Center)
• Diana Jean Stone, MA, LPC
• Eric N. Swensen, D.O.
• Robert P. Tyrrell, DDS
• Cindy Ann Wardell
• Nathan D. Whittaker, M.D.
• Makayla Marie Wynn, APRN, FNP-C

• Durable Medical Equipment & Medical Supplies in Kemmerer, WY
• Providers in Kemmerer, WY by specialty
• Durable Medical Equipment & Medical Supplies in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.