Summit Cancer Care PC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE009051 Issued in GA

Legal business name

SUMMIT CANCER CARE PC

Doing business as

Summit Cancer Care

Practice address

836 E 65TH St Ste 4
Savannah, GA 31405-4491

Phone

(912) 651-5767

Fax

(912) 354-7090

NPI assigned

Mar 20, 2007

Last updated

Apr 7, 2020By 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

L Robertson, PHARMD

Title

Pres, MD, Ao

Phone

(912) 651-5767

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• SUMMIT CANCER CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1942325402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E 65TH ST STE 4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054491",
            "telephone_number": "912-354-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 E 65TH ST STE 4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054491",
            "telephone_number": "912-651-5767",
            "fax_number": "912-354-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CANCER CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "L",
        "authorized_official_title_or_position": "PRES, MD, AO",
        "authorized_official_telephone_number": "912-651-5767",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009051",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2015659",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00165459A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMMIT CANCER CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SUMMIT CANCER CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Patrick Sullivan, PA-C
• Lori Elizabeth Sullivan, LMT
• Megan Summerlin, M.S.
• Adrian Summers
• Roland Steven Summers, MD
• Summit Cancer Care, P.C.
• Patricia Ann Sumner, SLP
• Sun Pain Institute LLC
• Suncrest Home Health of Georgia, Inc. (Adoration Home Health)
• Sundance Rehabilitation Agency LLC (Sundance Georgia Rehabilitation Agency)

• Community/Retail Pharmacy in Savannah, GA
• Providers in Savannah, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.