NPIMap

Individual provider Active NPI

John P Summerford, M.D.

  • Internal Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1659472009
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12146 Issued in AL
Practice address
1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone
(205) 759-2582
Fax
(205) 759-2985
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12146 AL Primary

Addresses

Primary practice location

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959

Mailing address

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone (205) 759-2582

Other identifiers 2

IdentifierTypeStateIssuer
700005261OtherALRAILROAD MEDICARE
000017012MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111000279 AL Practitioner - Internal Medicine 7618996588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuskaloosa Internal Medicine LLCGroup PAC ID 2264451137, 9 clinicians

Practice addresses (Care Compare)

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2959
Phone (205) 759-2582

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12146ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Health Care Authority CurrentSince Nov 25, 1996 Accepting new patients
The DCH Healthcare Authority CurrentSince Nov 25, 1996 Accepting new patients
Tuskaloosa Internal Medicine LLC Internal Medicine CurrentSince Jan 1, 1988 Accepting new patients
DCH Provider Services, LLC Current Accepting new patients

Locations

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

1100 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 759-2582

Networks

  • bcbs alabama network 01C0
  • bcbs alabama network 01G0
  • bcbs alabama network 01E0
  • bcbs alabama network 01B0
  • bcbs alabama network 01H0
  • bcbs alabama network 01A0

Interoperability endpoints

  • Direct secure messaging: admin@tuskintmed.e-mdsdirect.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 7

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1659472009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042959",
            "telephone_number": "205-759-2582",
            "fax_number": "205-759-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042959",
            "telephone_number": "205-759-2582",
            "fax_number": "205-759-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERFORD",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "12146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "700005261",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000017012",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.