Individual provider Active NPI

Courtney Marie Sumner

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1609238773
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.135941 Issued in OH
Practice address
3430 Burnet Ave, Medical Office Building 2ND Floor
ML 5026
Cincinnati, OH 45229-3026
Phone
(513) 636-7722
Fax
(513) 636-3737
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 35.135941 OH Primary

Addresses

Primary practice location

3430 Burnet Ave, Medical Office Building 2ND Floor
ML 5026
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave, ML 5021
Cincinnati, OH 45229-3818
Phone (513) 636-4225

Other practice location 1

571 S Floyd St
Suite 412
Louisville, KY 40202-3818
Phone (502) 629-8828

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20191007001407 OH Practitioner - Pediatric Medicine 7517298565 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Pediatrics CurrentSince Aug 11, 2019 Accepting new patients
CHMC Community Health Services Network Pediatrics Current Accepting new patients
CHMC Community Health Services Network Pediatrics CurrentSince Jul 3, 2023 Accepting new patients
CHMC Community Health Services Network Pediatrics Past Accepting new patients
Montgomery Pediatrics Incorporated Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3430 Burnet Ave
Ofc
Cincinnati, OH 45229
Phone (513) 636-7722

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

7502 State Rd
Ste 3350
Cincinnati, OH 45255
Phone (513) 231-3345

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/FmRItZc30RH60LjxwsIxQM4HGo6XcQXK/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/8872/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1609238773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE, ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293818",
            "telephone_number": "513-636-4225",
            "fax_number": "513-636-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 BURNET AVE, MEDICAL OFFICE BUILDING 2ND FLOOR",
            "address_2": "ML 5026",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-7722",
            "fax_number": "513-636-3737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 S Floyd St",
            "address_2": "Suite 412",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023818",
            "country_code": "US",
            "telephone_number": "502-629-8828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.135941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.