Individual provider Active NPI

Marlene M Summers, CNM

  • Obstetrics & Gynecology Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1659465755
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
1370482 Issued in FL
Practice address
449 SE Baya Drive
Lake City, FL 32025
Phone
(386) 755-0500
Fax
(386) 755-9217
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 1370482 FL Primary

Addresses

Primary practice location

449 SE Baya Drive
Lake City, FL 32025

Mailing address

6400 W Newberry Rd
Ste 207
Gainesville, FL 32605-6600
Phone (352) 371-2011

Other identifiers 3

IdentifierTypeStateIssuer
240386OtherFLAVMED
Y9008OtherFLBCBS PROVIDER NUMBER
340059000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013000428 FL Practitioner - Certified Nurse Midwife (CNM) 2466740188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

3140 NW Medical Ctr LN
Suite 140
Lake City, FL 32055-4735
Phone (386) 438-5095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1370482FLMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC CurrentSince Sep 1, 2016 Accepting new patients
Pastor H. Rios, MD Past Accepting new patients
Womencare PA Past Accepting new patients
Daina P Greene MD PA Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

199 S US Highway 17
East Palatka, FL 32131
Phone (386) 325-6699

6440 W Newberry Rd
Ste 508
Gainesville, FL 32605
Phone (352) 332-7222

6400 W Newberry Rd
Ste 207
Gainesville, FL 32605
Phone (352) 371-2011

3140 NW Medical Center Ln
Ste 140
Lake City, FL 32055
Phone (386) 438-5095

3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814

Interoperability endpoints

  • Direct secure messaging: marlene.summers.2@2183.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1659465755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W NEWBERRY RD",
            "address_2": "STE 207",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326056600",
            "telephone_number": "352-371-2011",
            "fax_number": "352-384-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 SE BAYA DRIVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-755-0500",
            "fax_number": "386-755-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MARLENE",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "1370482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "240386",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "Y9008",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340059000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.