NPIMap

Organization Active NPI

Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Holbrook, AZ
National Provider Identifier
1740934678
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SUMMIT HEALTHCARE MEDICAL ASSOCIATES
Practice address
1401 W Florida St
Holbrook, AZ 86025-2218
Phone
(928) 524-2020
Fax
(928) 524-3755
NPI assigned
Feb 9, 2022
Last updated
Feb 9, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT HEALTHCARE ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Kenneth Robert Allen
Title
Chief Practice Officer
Phone
(928) 537-4375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1401 W Florida St
Holbrook, AZ 86025-2218

Mailing address

2200 E Show Low Lake Rd
Show Low, AZ 85901-7831
Phone (928) 537-6393

Other names 1

  • Summit Healthcare Family Medicine Holbrook Other name

National Provider Directory

National Provider Directory
Tax ID family
Summit Healthcare Medical Associates9 organizations share this tax ID, including this one
Part of
Summit Healthcare Assoc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1740934678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017831",
            "telephone_number": "928-537-6393",
            "fax_number": "928-532-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W FLORIDA ST",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860252218",
            "telephone_number": "928-524-2020",
            "fax_number": "928-524-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT HEALTHCARE MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT HEALTHCARE ASSOCIATION",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF PRACTICE OFFICER",
        "authorized_official_telephone_number": "928-537-4375"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Healthcare Family Medicine Holbrook",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holbrook, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.