Summit Ketamine, PC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

SUMMIT KETAMINE, PC

Doing business as

Summit Ketamine Innovations

Practice address

19284 Cottonwood Dr Ste 200
Parker, CO 80138-3881

Phone

(719) 641-7614

NPI assigned

Mar 18, 2019

Last updated

Mar 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Lynn Coakley, DONPI 1578616413

Title

President

Phone

(719) 641-7614

Specialties & licenses 1

Addresses

Other names 1

• Summit Ketamine Innovations Doing business as

Electronic endpoints 1

Interoperability endpoints

• Direct secure messaging: info@summitketamine.com

Practitioners 1

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.

• Sarah Lynn Coakley, D.O.

  • Anesthesiology Physician
  • Colorado Springs, CO
  • NPI 1578616413
  Authorized official Same address or phone

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552867200000",
    "number": "1912466004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2077 S CLARKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802104105",
            "telephone_number": "719-641-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19284 COTTONWOOD DR STE 200",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801383881",
            "telephone_number": "719-641-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT KETAMINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A",
        "authorized_official_last_name": "COAKLEY",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-641-7614",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@summitketamine.com",
            "affiliation": "N",
            "address_1": "19284 Cottonwood Dr Ste 200",
            "city": "Parker",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801383881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Summit Ketamine Innovations",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanja Sukovic, D.C.
• Karen Elizabeth Suleks Freimanis, PHYSICAL THERAPIST
• Mariana Christine Sullivan Martinez
• Erin Jane Sullivan, OTR/L
• Janna Summerlin, LCSW
• Summit Kids Physical Therapy, LLC
• Sun Clinic, Inc.
• John H Sun, MD
• Sunny Speech Solutions, LLC
• Sunshine Enterprises Limited

• Infusion Therapy Clinic/Center in Parker, CO
• Providers in Parker, CO by specialty
• Infusion Therapy Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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.