Active NPI
Summa Physicians LLC
Doing business as Summa Health Medical Group
- Sports Medicine (Family Medicine) Physician
- Medina, OH
National Provider Identifier
1649559964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- Legal business name
- SUMMA PHYSICIANS LLC
- Doing business as
- Summa Health Medical Group
- Practice address
- 3780 Medina Rd Ste 105
Medina, OH 44256-9313 - Phone
- (330) 375-4100
- Fax
- (234) 312-2329
- NPI assigned
- Aug 4, 2011
- Last updated
- Oct 13, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wendy Carson
- Title
- Manager, Payer Enrollment
- Phone
- (234) 312-5691
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | Primary |
Addresses
Primary practice location
3780 Medina Rd Ste 105
Medina, OH 44256-9313
Mailing address
1077 Gorge Blvd
Akron, OH 44310-2408
Phone (234) 312-5873
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0055648 | Medicaid | OH |
Other names 1
- Summa Health Medical Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040116000295 | OH | Part B Supplier - Clinic/Group Practice | 2961303532 |
Receives reassigned benefits from 729 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryLocations
3780 Medina Rd
Ste 105
Medina, OH 44256
Phone (330) 722-2341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1760313600000",
"number": "1649559964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1077 GORGE BLVD",
"city": "AKRON",
"state": "OH",
"postal_code": "443102408",
"telephone_number": "234-312-5873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3780 MEDINA RD STE 105",
"city": "MEDINA",
"state": "OH",
"postal_code": "442569313",
"telephone_number": "330-375-4100",
"fax_number": "234-312-2329"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMA PHYSICIANS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-08-04",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A",
"authorized_official_last_name": "CARSON",
"authorized_official_first_name": "WENDY",
"authorized_official_title_or_position": "MANAGER, PAYER ENROLLMENT",
"authorized_official_telephone_number": "234-312-5691"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0055648",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Summa Health Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Medina, OH
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Summa Physicians LLC (Summa Health Medical Group)
- Desiree Summers, LPCC-S
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.