Jeffrey Allen Summerhill, D.O.
Individual provider Active NPI Emergency Medicine Physician · Eureka Springs, AR
NPI 1922094432 · NPPES record last updated Nov 26, 2012
Key facts
- NPI
- 1922094432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- E3568 (AR)
- Practice address
- 24 Norris St
Emergency Dept
Eureka Springs, AR 72632-3541 - Phone
- (479) 253-7400
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230316000814 | AR | Practitioner - General Practice | 3678472149 |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E3568 | AR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Fork Health and Wellness LLC | Current |
Accepting new patients | |
| Watch Care, LLC | Family Medicine | Past | Accepting new patients |
| McGehee Desha County Hospital | Past | Accepting new patients | |
| Jacksonville Emergency Medicine LLC | Emergency Medicine | Past | Accepting new patients |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Locations
106 W Locust St
Salem, AR 72576
Phone (870) 500-4225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | E3568 | AR | Yes |
| Family Medicine Physician | 207Q00000X | E3568 | AR |
Addresses
Primary practice location
24 Norris St
Emergency Dept
Eureka Springs, AR 72632-3541
Mailing address
PO Box 960454
Oklahoma City, OK 73196-0454
Phone (800) 684-1598
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149414003 | Medicaid | AR | |
| P01071363 | Other | AR | RRMCARE |
Other providers in Eureka Springs, AR
- Smith Drug Company Inc
- Smith Drug Company Inc
- Danny L Smith
- Jennie Marie Spears
- St Johns Clinic Inc
- Tree of Life Chiropractic Inc
- Letitia Trent
- Ruthann Marie Tucker
- Joseph Tuttle
- Stephen Van Horn
All providers in Eureka Springs, AR · Emergency Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.