Summit City Physical Medicine LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SUMMIT CITY PHYSICAL MEDICINE LLC

Practice address

9604 Coldwater Rd Ste 101
Fort Wayne, IN 46825-2096

Phone

(260) 710-8660

NPI assigned

Nov 13, 2023

Organization subpart

No

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

Authorized official

Name

Mark Zolman, MDNPI 1467455436

Title

Ceo

Phone

(260) 710-8660

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark E Zolman, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Fort Wayne, IN
  • NPI 1467455436
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1598539330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9604 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252096",
            "telephone_number": "260-710-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9604 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252096",
            "telephone_number": "260-710-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CITY PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "ZOLMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-710-8660",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Sullivan
• Summit Allergy Inc
• Summit Anesthesia, LLC
• Summit BHC Ft Wayne LLC
• Summit City Health Clinic
• Summit City Prosthetics & Orthotics Inc
• Summit City Smiles
• Summit Counseling and Coaching LLC
• Summit Dental Group PC
• Summit Hearing Solutions,Inc.

• Physical Medicine & Rehabilitation Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.