Organization Active NPI

Summit Internal Medicine

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1952454746
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00021252 Issued in AL
Legal business name
SUMMIT INTERNAL MEDICINE
Practice address
3570 Grandview Parkway Suite 100-a
Birmingham, AL 35243-2033
Phone
(205) 595-9222
Fax
(205) 595-9444
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Dr. David Frank Wynne, MDNPI 1184712911
Title
Doctor
Phone
(205) 595-9222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 00021252 AL Primary

Addresses

Primary practice location

3570 Grandview Parkway Suite 100-a
Birmingham, AL 35243-2033

Mailing address

3570 Grandview Parkway
Suite 100-a
Birmingham, AL 35243-2033
Phone (205) 595-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050124000201 AL Part B Supplier - Clinic/Group Practice 1355391889 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1015641Summit Internal Medicine PC3570 Grandview Parkway Suite 100-a, Birmingham, AL 35243Certificate of waiverAug 10, 2027

National Provider Directory

National Provider Directory

Locations

860 Montclair Rd
Ste 764
Birmingham, AL 35213
Phone (205) 595-9222

3570 Grandview Pkwy
Ste 100A
Birmingham, AL 35243
Phone (205) 595-9222

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1952454746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3570 GRANDVIEW PARKWAY",
            "address_2": "SUITE 100-A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432033",
            "telephone_number": "205-595-9222",
            "fax_number": "205-595-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 GRANDVIEW PARKWAY SUITE 100-A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352432033",
            "telephone_number": "205-595-9222",
            "fax_number": "205-595-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "205-595-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00021252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.