Summit OB GYN PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

7203A Issued in WY

Legal business name

SUMMIT OB GYN PC

Practice address

1414 W 4TH St
Gillette, WY 82716-3328

Phone

(307) 299-4496

NPI assigned

Apr 13, 2016

Organization subpart

No

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

Authorized official

Name

Anna Wilson

Title

Practice Manager

Phone

(307) 682-6263

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 5

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

• Stefani Bissonette, MD

  • Obstetrics & Gynecology Physician
  • Douglas, WY
  • NPI 1407200660
  Medicare reassignment Care Compare group NPD
• Angela E Biggs, MD

  • Obstetrics & Gynecology Physician
  • Gillette, WY
  • NPI 1689787814
  Medicare reassignment Care Compare group
• Courtney Goodnough, NP

  • Nurse Practitioner
  • Gillette, WY
  • NPI 1467010165
  Medicare reassignment Care Compare group
• Kimberlie R Parks, NP-C

  • Family Nurse Practitioner
  • Gillette, WY
  • NPI 1770186470
  Medicare reassignment Care Compare group
• Jeffrey J Anderson, D.O.

  • Obstetrics & Gynecology Physician
  • Gillette, WY
  • NPI 1043223696
  Medicare reassignment

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1942664107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-299-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT OB GYN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "307-682-6263"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WY",
            "license": "7203A",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WY",
            "license": "8045A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WY",
            "license": "8335A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Stumbaugh
• Crysta Jean Sullivan, DNP, FNP-C
• Renee Sullivan, M.A., L.P.C.
• Summit Anesthesiology Consultants, LLC
• Summit Health Associates, LLC
• Janna Swanson
• Swartz Chiropractic, P.C.
• Gregory Wayne Swartz, D.C.
• Ian R Swift, MD
• Hunter Thomas Sylte, DPT

• Specialist in Gillette, WY
• Providers in Gillette, WY by specialty
• Specialist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.