NPIMap

Organization Active NPI

Summit Orthopaedics Management and Consulting, LLC

Doing business as Summit Orthopaedics

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1851485031
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SUMMIT ORTHOPAEDICS MANAGEMENT AND CONSULTING, LLC
Doing business as
Summit Orthopaedics
Practice address
2321 Coronado St
Idaho Falls, ID 83404-7407
Phone
(208) 227-1100
Fax
(208) 227-1087
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Authorized official

Name
Dr. Philip McCowin, M.D.NPI 1730297706
Title
Physician/Partner
Phone
(208) 227-1110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

2321 Coronado St
Idaho Falls, ID 83404-7407

Mailing address

2321 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 227-1100

Other identifiers 1

IdentifierTypeStateIssuer
806422900MedicaidID

Other names 1

  • SUMMIT ORTHOPAEDICS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000543 ID Part B Supplier - Clinic/Group Practice 6204731227 Receives reassigned benefits from 13 practitioners
Practice locations: Idaho Falls, ID; Pocatello, ID

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

3200 Channing Way
Idaho Falls, ID 83404
Phone (208) 528-2925

2321 Coronado St
Idaho Falls, ID 83404
Phone (208) 227-1100

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1851485031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-227-1100",
            "fax_number": "208-227-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-227-1100",
            "fax_number": "208-227-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ORTHOPAEDICS MANAGEMENT AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "MCCOWIN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "208-227-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806422900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMMIT ORTHOPAEDICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.