PGN Op Summit LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PGN OP SUMMIT LLC

Practice address

935 N Cassady Ave
Columbus, OH 43219-2283

Phone

(614) 252-4987

NPI assigned

Sep 4, 2020

Organization subpart

No

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

Authorized official

Name

Samuel Goldner

Title

Authorized Official

Phone

(732) 645-9800

Specialties & licenses 2

Addresses

Other names 1

• Summit's Trace Healthcare Center Doing business as

Locations

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1871107961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 CHESTNUT ST STE 102",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 N CASSADY AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192283",
            "telephone_number": "614-252-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGN OP SUMMIT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "GOLDNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "732-645-9800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit's Trace Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Pfister
• John Anthony Pfizenmayer
• Hannah Pfleuger, PA-C
• Jonathan Jay Pflueger, O.D.
• PG Home Care Inc
• Pha Lab Services
• Daniel Lee Phalen, PHD
• Marcie Phalen
• Ha T. Pham
• Nataly Anessa-Elise Pham, LSW

• Skilled Nursing Facility in Columbus, OH
• Providers in Columbus, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.