Blue Summit Palliative Care LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BLUE SUMMIT PALLIATIVE CARE LLC

Practice address

11113 Houze Rd Ste 150
Roswell, GA 30076-1495

Phone

(470) 395-2510

NPI assigned

Sep 20, 2024

Organization subpart

Yes

Parent organization

BLUE SUMMIT HOLDING LLCAs reported in NPPES

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

Authorized official

Name

Amanda Delpozo McKissick

Title

Ceo

Phone

(470) 395-2510

Specialties & licenses 2

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Blue Summit Hospice and Palliative Care, Inc

  • Community Based Hospice Care Agency
  • Snellville, GA
  • NPI 1245953819

  Member Of

  NPD member

Locations

Practitioners 5

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

• Lakshman Kumar Dinavahi, MD

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1528233723
  NPD
• Ashley Riddle Flo, FNP

  • Family Nurse Practitioner
  • Greensboro, GA
  • NPI 1932757994
  NPD
• Samantha Suzanne Spell, RN, NP-C

  • Family Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1811048663
  NPD
• Andrea D Turner, NP

  • Adult Health Nurse Practitioner
  • Blairsville, GA
  • NPI 1740750355
  NPD
• Kenya Shannise Williams, FNP-C

  • Registered Nurse
  • Roswell, GA
  • NPI 1982566121
  NPD

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1841017985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11113 HOUZE RD STE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761495",
            "telephone_number": "470-395-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11113 HOUZE RD STE 150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761495",
            "telephone_number": "470-395-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SUMMIT PALLIATIVE CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE SUMMIT HOLDING LLC",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "DELPOZO MCKISSICK",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-395-2510"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernice K Bloom, PT
• Ingrid Lea Bloomfield, NURSE PRACTITIONER
• Priti Shah Bloor, DDS
• Blue Line Medical Products, LLC
• Blue Summit Hospice and Palliative Care of Roswell LLC
• Kimberlyn Boddie, RBT
• Body G O a L S Physical Therapy & Wellness
• Jessica Ginn Boehm, M.S. CCC-SLP
• Barbara Ann Bogartz, LPC
• Xander Boggs

• Case Management Agency in Roswell, GA
• Providers in Roswell, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.