Summit Health Professionals

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUMMIT HEALTH PROFESSIONALS

Practice address

3760 Washington Pkwy
Idaho Falls, ID 83404-7593

Phone

(208) 524-4953

Fax

(208) 524-7335

NPI assigned

Aug 16, 2005

Last updated

Nov 3, 2008By 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

Mr. Nikola Andersen

Title

Physician/Partner

Phone

(208) 524-4953

Specialties & licenses 4

Addresses

Other identifiers 1

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.

• Richard A New, M.D.

  • Psychiatry Physician
  • Ammon, ID
  • NPI 1699718619
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1649262825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047593",
            "telephone_number": "208-524-4953",
            "fax_number": "208-524-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047593",
            "telephone_number": "208-524-4953",
            "fax_number": "208-524-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT HEALTH PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "NIKOLA",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "208-524-4953",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-323",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LCSW-1311",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M8621",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806797700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sullivan Mental Health Services LLC
• Jessie Elaine Sullivan, LCPC,LMFT
• Joshua Summers, DO
• Patti Joleen Summers, LPC
• Summit Eyecare PLLC
• Summit Orthopaedics Management and Consulting, LLC (Summit Orthopaedics)
• Summit Orthopaedics Management and Consulting, LLC
• Summus Counseling, LLC
• Sunnyside Dental Care LLC
• Sunnyside Dental Care PC

• Community/Behavioral Health Agency in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.