Individual provider Active NPI

Stephen D Summerow, O.D.

  • Optometrist
  • Warner Robins, GA
National Provider Identifier
1912039595
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1591 Issued in GA
Practice address
216 Corder Rd
Warner Robins, GA 31088
Phone
(478) 923-5872
Fax
(478) 922-9020
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1591 GA Primary

Addresses

Primary practice location

216 Corder Rd
Warner Robins, GA 31088

Mailing address

216 Corder Rd
Warner Robins, GA 31088-3604
Phone (478) 322-4107

Other practice location 1

5955 Zebulon Rd
Macon, GA 31210-2030
Phone (478) 477-3555

Other practice location 2

1009 Saint Patricks Dr
Perry, GA 31069-2144
Phone (478) 987-3702

Other identifiers 2

IdentifierTypeStateIssuer
000764189YMedicaidGA
00764189RMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110708000356 GA Practitioner - Optometry 7911185228 Reassigns benefits to 1 organization
Practice locations: Macon, GA; Perry, GA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gayton Health Centre PCGroup PAC ID 9830142710, 13 clinicians

Practice addresses (Care Compare)

856 1St St
Macon, GA 31201-6875
Phone (478) 741-1740

Merit-based Incentive Payment System (MIPS)

Final score
90.09 of 100Reported as group
Quality
90.67
Improvement activities
40
Cost
79.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1591GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gayton Health Centre, PC Optometrist CurrentSince Apr 15, 2015 Accepting new patients
Gayton Health Centre, PC Past Accepting new patients

Locations

131 Highway 32 Byp
Alma, GA 31510
Phone (912) 632-7623

112 Mall Rd
Dublin, GA 31021
Phone (478) 353-8500

117 W Jackson St
Dublin, GA 31021

440 Taylors Mill Rd
Fort Valley, GA 31030
Phone (478) 825-8223

856 1st St
Macon, GA 31201
Phone (478) 741-1740

312 Redfern Vlg
St Simons Island, GA 31522
Phone (912) 638-8652

312 Redfern Vlg
#2522
St Simons Island, GA 31522

700 Maple Dr
Vidalia, GA 30474
Phone (912) 537-1991

100 Spillers Way
Warner Robins, GA 31088

216 Corder Rd
Warner Robins, GA 31088
Phone (912) 923-5872

Interoperability endpoints

  • Direct secure messaging: sdsummerow@eyesightassoc.direct.eyemdemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1912039595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 CORDER RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883604",
            "telephone_number": "478-322-4107",
            "fax_number": "478-922-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 CORDER RD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-923-5872",
            "fax_number": "478-922-9020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zebulon Rd",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312102030",
            "country_code": "US",
            "telephone_number": "478-477-3555",
            "fax_number": "478-471-9042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Saint Patricks Dr",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "GA",
            "postal_code": "310692144",
            "country_code": "US",
            "telephone_number": "478-987-3702",
            "fax_number": "478-987-3943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMEROW",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000764189Y",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00764189R",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.