NPIMap

Organization Active NPI

Summers Pharmacy

  • Community/Retail Pharmacy
  • Clinton, MO
National Provider Identifier
1780921072
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2013000144 Issued in MO
Legal business name
SUMMERS PHARMACY
Practice address
605 Pawnee St
Clinton, MO 64735-1459
Phone
(660) 885-3034
Fax
(660) 885-5888
NPI assigned
Jan 7, 2013
Last updated
Nov 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMERS PHARMACY ENTERPRISES, CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Dr. Ryan Summers, PHARMDNPI 1720076037
Title
Pharmacist/Owner
Phone
(660) 885-3034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2013000144 MO Primary

Addresses

Primary practice location

605 Pawnee St
Clinton, MO 64735-1459

Mailing address

605 Pawnee St
Clinton, MO 64735-2757
Phone (660) 885-3034

Other identifiers 1

IdentifierTypeStateIssuer
600002706MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140306001649 MO Part B Supplier - Mass Immunization (Roster Biller Only) 3476783770 1 other NPI on this enrollment
Practice locations: Butler, MO; Clinton, MO
O20201119000616 MO Part B Supplier - Pharmacy 3476783770 1 other NPI on this enrollment
Practice locations: Butler, MO; Clinton, MO
O20210706001148 MO DME Supplier - Pharmacy 3476783770 Practice locations: Clinton, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Summers Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1780921072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 PAWNEE ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647352757",
            "telephone_number": "660-885-3034",
            "fax_number": "660-885-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 PAWNEE ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351459",
            "telephone_number": "660-885-3034",
            "fax_number": "660-885-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERS PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERS PHARMACY ENTERPRISES, CORP",
        "enumeration_date": "2013-01-07",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "660-885-3034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2013000144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600002706",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.

Verify at the official NPI Registry.