NPIMap

Individual provider Active NPI

Evan L. Summers, DO

  • Hospitalist Physician
  • Oxford, MS
National Provider Identifier
1922074384
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
16638 Issued in MS
Practice address
2301 South Lamar Blvd
Oxford, MS 38655
Phone
(662) 232-8568
Fax
(662) 513-1450
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16638 MS
Hospitalist Physician 208M00000X 16638 MS Primary

Addresses

Primary practice location

2301 South Lamar Blvd
Oxford, MS 38655

Mailing address

P.O. Box 405827
Atlanta, GA 30384-5827
Phone (901) 227-4068

Other identifiers 2

IdentifierTypeStateIssuer
00121440MedicaidMS
02453398MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912001091 MO Practitioner - Internal MedicinePractitioner - Hospitalist 6002801396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
College of Osteo Med of the Pacific at Pomona, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cole Physician Services LLCGroup PAC ID 0648420810, 23 clinicians

Practice addresses (Care Compare)

10 S Hospital Dr
Fulton, MO 65251-2510
Phone (573) 642-3376

Hospital & facility affiliations

  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
13468CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Louisiana, Inc. CurrentSince Mar 1, 2013 Accepting new patients
St. Tammany Parish Hospital Service District No 1 CurrentSince Nov 8, 2016 Accepting new patients
Cole Physician Services LLC Hospitalist CurrentSince Aug 10, 2022 Accepting new patients
St Tammany Parish Hospital Service District No 1 Internal Medicine CurrentSince Nov 8, 2016 Accepting new patients
Magnolia Medical Center Internal Medicine Past Accepting new patients
River Oaks Management Company LLC Internal Medicine Past Accepting new patients
SSM Regional Health Services Past Accepting new patients
Magnolia Internal Medical Clinic Internal Medicine PastSince Jun 30, 2006 Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1001 Gause Blvd
Slidell, LA 70458
Phone (985) 280-2200

10 S Hospital Dr
Fulton, MO 65251
Phone (573) 592-6550

620 E Monroe St
Mexico, MO 65265
Phone (573) 582-5000

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1922074384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "901-227-4068",
            "fax_number": "228-575-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 SOUTH LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "662-232-8568",
            "fax_number": "662-513-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "EVAN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "16638",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "16638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121440",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02453398",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.