Summa Physicians LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

SUMMA PHYSICIANS LLC

Practice address

1790 Graybill Rd Ste 250
Green, OH 44685-7997

Phone

(330) 375-6917

Fax

(330) 535-7539

NPI assigned

Oct 25, 2011

Organization subpart

No

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

Authorized official

Name

Wendy Carson

Title

Manager, Payer Enrollment

Phone

(234) 312-5691

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Summa Health Medical Group Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1831475656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GORGE BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102408",
            "telephone_number": "237-312-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 GRAYBILL RD STE 250",
            "city": "GREEN",
            "state": "OH",
            "postal_code": "446857997",
            "telephone_number": "330-375-6917",
            "fax_number": "330-535-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMA PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MANAGER, PAYER ENROLLMENT",
        "authorized_official_telephone_number": "234-312-5691"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0056019",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summa Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Marie Smith, PMHNP
• Samuel Timothy Snyder, DC
• Tabetha Staten, NP
• Still Human Restoration
• Summa Physicians LLC
• Haley Renee Taylor
• Alanna Monay Thomas
• Natalie Erin Tilton, LPC
• Suzanne Van Nostran, LPCC
• Michael Warner, LPC

• All providers in Green, OH
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.