NPIMap

Organization Active NPI

Summit Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Loveland, CO
National Provider Identifier
1912966458
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
34496 Issued in CO
Legal business name
SUMMIT PATHOLOGY
Practice address
5802 Wright Dr
Loveland, CO 80538-8806
Phone
(970) 212-0530
Fax
(970) 212-0553
NPI assigned
Mar 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Dr. Harry Wentzell Hamner, MDNPI 1902865439
Title
President
Phone
(970) 350-6400

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZB0001X 37647 CO
Hematology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZH0000X 35098 CO
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X 34496 CO Primary

Addresses

Primary practice location

5802 Wright Dr
Loveland, CO 80538-8806

Mailing address

5802 Wright Dr
Loveland, CO 80538-8806
Phone (970) 212-0530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, WY, NE3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040331000656 CO Part B Supplier - Clinic/Group Practice 3971595968 Receives reassigned benefits from 30 practitioners
6 other NPIs on this enrollment
Practice locations: Loveland, CO; Sterling, CO; Greeley, CO; Fort Collins, CO
O20150730012393 WY Part B Supplier - Clinic/Group Practice 3971595968 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casper, WY; Cheyenne, WY; Laramie, WY
O20251021004232 NE Part B Supplier - Clinic/Group Practice 3971595968 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Scottsbluff, NE

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

175 S Union Blvd
Ste 360
Colorado Springs, CO 80910

2555 E 13th St
Ste 120
Loveland, CO 80537
Phone (970) 330-5824

2360 E Pershing Blvd
Cheyenne, WY 82001
Phone (307) 778-7322

Practitioners & affiliated clinicians

Practitioners 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1912966458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 WRIGHT DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388806",
            "telephone_number": "970-212-0530",
            "fax_number": "970-212-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 WRIGHT DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388806",
            "telephone_number": "970-212-0530",
            "fax_number": "970-212-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "HAMNER",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "WENTZELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-350-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "CO",
            "license": "37647",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "CO",
            "license": "35098",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CO",
            "license": "34496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

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