Organization Active NPI

Summit Medical Group, Inc

Doing business as St. Elizabeth Physicians

  • Family Medicine Physician
  • Highland Heights, KY
National Provider Identifier
1790042430
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT MEDICAL GROUP, INC
Doing business as
St. Elizabeth Physicians
Practice address
2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone
(859) 781-4111
Fax
(859) 441-5214
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name
Maria Rankin
Title
Avp-Revenue Cycle
Phone
(859) 344-5555

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Urgent Care Clinic/Center 261QU0200X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2626 Alexandria Pike
Highland Heights, KY 41076-1530

Mailing address

1360 Dolwick Drive
Erlanger, KY 41018
Phone (859) 344-5555

Other names 1

  • St. Elizabeth Physicians Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0324598St Elizabeth Physicians Highland Heights2626 Alexandria Pike, Cold Spring, KY 41076Provider-performed microscopyAug 31, 2026
18D2053213St Elizabeth Physicians Urgents Care2626 Alexandria Pike, Highland Heights, KY 41076Certificate of waiverJan 27, 2027
18D2154289St Elizabeth Physician Dermatology2626 Alexandria Pike, Highland Heights, KY 41076Provider-performed microscopySep 10, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1790042430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 DOLWICK DRIVE",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "41018",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 ALEXANDRIA PIKE",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410761530",
            "telephone_number": "859-781-4111",
            "fax_number": "859-441-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "RANKIN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "AVP-REVENUE CYCLE",
        "authorized_official_telephone_number": "859-344-5555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Elizabeth Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highland Heights, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.