NPIMap

Organization Active NPI

Summit Medical Specialists PSC

  • Obstetrics & Gynecology Physician
  • Owensboro, KY
National Provider Identifier
1861928228
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SUMMIT MEDICAL SPECIALISTS PSC
Practice address
3821 Vincent Station Dr
Owensboro, KY 42303-9315
Phone
(270) 478-5334
Fax
(270) 216-6920
NPI assigned
May 4, 2017
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Dr. Suzanne MV Rashidian, DONPI 1033315189
Title
Co-Owner
Phone
(270) 478-5334

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3821 Vincent Station Dr
Owensboro, KY 42303-9315

Mailing address

PO Box 3276
Evansville, IN 47731-3276
Phone (812) 473-0181

Other names 1

  • Summit Obstetrics & Gynecology PSC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170623001663 KY Part B Supplier - Clinic/Group Practice 6507134012 Receives reassigned benefits from 9 practitioners
Practice locations: Owensboro, KY

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
18D2131632Summit Medical Specialists3821 Vincent Station Drive, Owensboro, KY 42303ComplianceSep 26, 2027

National Provider Directory

National Provider Directory

Locations

1023 N Elm St
Henderson, KY 42420
Phone (270) 826-0838

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1861928228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 VINCENT STATION DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039315",
            "telephone_number": "270-478-5334",
            "fax_number": "270-216-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL SPECIALISTS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "RASHIDIAN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "MV",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "270-478-5334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "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
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Obstetrics & Gynecology PSC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.