Organization Active NPI

Summit Rehabilitation Medicine, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Copley, OH
National Provider Identifier
1760414247
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SUMMIT REHABILITATION MEDICINE, INC.
Practice address
4389 Medina Rd
Copley, OH 44321-1388
Phone
(234) 678-9332
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Kennard Ford, MD
Title
President
Phone
(234) 678-9332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4389 Medina Rd
Copley, OH 44321-1388

Mailing address

PO Box 14807
Copley, OH 44321-4807
Phone (234) 678-9332

Other practice location 1

3625 Marsh Rd
Stow, OH 44224-5823
Phone (330) 784-9306

Other practice location 2

20 Olive St Ste 200
Akron, OH 44310-3169
Phone (330) 784-9306

Other identifiers 1

IdentifierTypeStateIssuer
0786823MedicaidOH

National Provider Directory

National Provider Directory

Locations

3975 Embassy Pkwy
Ste 2
Akron, OH 44333
Phone (330) 668-4094

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1760414247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14807",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443214807",
            "telephone_number": "234-678-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 MEDINA RD",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443211388",
            "telephone_number": "234-678-9332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3625 Marsh Rd",
            "address_purpose": "LOCATION",
            "city": "Stow",
            "state": "OH",
            "postal_code": "442245823",
            "country_code": "US",
            "telephone_number": "330-784-9306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Olive St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443103169",
            "country_code": "US",
            "telephone_number": "330-784-9306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT REHABILITATION MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "KENNARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "234-678-9332",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0786823",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Copley, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.