Active NPI
Brad Sumrell, M.D.
- Pediatrics Physician
- Clovis, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A40182
- Practice address
- 275 W Herndon Ave
Clovis, CA 93612-0204 - Phone
- (559) 324-6200
- Fax
- (559) 324-6280
- NPI assigned
- Nov 8, 2005
- Last updated
- Aug 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A40182 | CA | Primary |
Addresses
Primary practice location
275 W Herndon Ave
Clovis, CA 93612-0204
Mailing address
275 W Herndon Ave
Clovis, CA 93612-0204
Phone (559) 324-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A401820 | Medicaid | CA | |
| 77040368493612B002 | Other | CA | CHAMPUS |
| 00A401820 | Other | CA | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40182 | CA | MD | General Practice Dentistry |
| A40182 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Foundation Medical Group | Current | Accepting new patients | |
| Community Foundation Medical Group | Current | Accepting new patients | |
| Fresno Community Hospital and Medical Center | Past | Accepting new patients | |
| Saint Agnes Medical Center | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Valley Children's Hospital | Past | Accepting new patients |
Locations
275 W Herndon Ave
Clovis, CA 93612
Phone (559) 321-4255
2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sante' Foundation Medical Group
- Internal Medicine Physician
- Fresno, CA
- NPI 1811258510
-
dba Sante' Foundation Medical Group
- Orthopaedic Surgery Physician
- Fresno, CA
- NPI 1376056721
-
dba Community Regional Medical Center
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1205845567
-
- Children's Hospital
- Madera, CA
- NPI 1952312043
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187740800000",
"number": "1952382749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 W HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120204",
"telephone_number": "559-324-6200",
"fax_number": "559-324-6280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W HERNDON AVE",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936120204",
"telephone_number": "559-324-6200",
"fax_number": "559-324-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMRELL",
"first_name": "BRAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2007-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A40182",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A401820",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "77040368493612B002",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "00A401820",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.