Misha Anne Summerhays, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2014020543 Issued in MO

Practice address

2707 W Edgewood Dr
Suite 102
Jefferson City, MO 65109-5888

Phone

(573) 761-1830

Fax

(573) 761-1829

NPI assigned

Oct 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Misha A Holte Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• SPS Practice Group, LLC

  • Plastic Surgery Physician
  • Columbia, MO
  • NPI 1053046888
  NPD

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1780968701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 W EDGEWOOD DR",
            "address_2": "SUITE 102",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095888",
            "telephone_number": "573-761-1830",
            "fax_number": "573-761-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERHAYS",
        "first_name": "MISHA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2014020543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISHA",
            "last_name": "HOLTE",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Elizabeth Grace Su, CPNP
• Diana Suleman, DMD
• Crystal Sullivan, D.O.
• Denae Marie Sullivan, MS, CCC-SLP
• Theresa Sullivan
• Sunrise Counseling LLC
• Sunshine Chiropractic LLC
• Surgicare of Missouri, P.C.
• Sharmila Suri Mohanram, MD
• Pamala S Swartz, FNP

• Physician Assistant in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.