Summit Medical Group LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SUMMIT MEDICAL GROUP LLC

Practice address

6310 Stevens Forest Rd Ste 200
Columbia, MD 21046-1068

Phone

(410) 740-9001

Fax

(410) 740-9005

NPI assigned

Jun 23, 2021

Last updated

Dec 13, 2023By 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

Njideka Udochi, MDNPI 1952580821

Title

Owner

Phone

(410) 245-2414

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

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

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Njideka Udochi, MD

  • Family Medicine Physician
  • Columbia, MD
  • NPI 1952580821
  Medicare reassignment Care Compare group NPD Authorized official
• Betrand A Ekenja, DNP, CRNP

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1790163830

  MD

  Medicare reassignment Care Compare group NPD
• Oluwadamilola Akinsola

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1326554809
  Medicare reassignment NPD
• Anthea Edu Nwandu, MD

  • Infectious Disease Physician
  • Baltimore, MD
  • NPI 1609861459
  Medicare reassignment NPD
• Michael C Obiefune, MD

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1073552881
  Medicare reassignment NPD
• Svetlana Paul, MD

  • General Practice Physician
  • Columbia, MD
  • NPI 1770112906

  Multi-Specialty

  Medicare reassignment NPD
• Chichi Udochi

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1477016517

  MD

  Medicare reassignment NPD
• Yewande Olasimbo, PA-C

  • Physician Assistant
  • Columbia, MD
  • NPI 1265771109
  Medicare reassignment
• Joy Chyddy Umeobi

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
  • NPI 1346832649

  Single Specialty

  NPD

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1952970816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14520 EDGEWOODS WAY",
            "city": "GLENELG",
            "state": "MD",
            "postal_code": "217379608",
            "telephone_number": "410-245-2414",
            "fax_number": "410-740-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 STEVENS FOREST RD STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461068",
            "telephone_number": "410-740-9001",
            "fax_number": "410-740-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7310 Ritchie Hwy",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210613065",
            "country_code": "US",
            "telephone_number": "410-684-5934",
            "fax_number": "410-684-5939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "UDOCHI",
        "authorized_official_first_name": "NJIDEKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-245-2414",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D00051897",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "685900301",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Sullivan
• Emily Summers
• Neal Summers
• Summit Ambulatory Surgical Center, LLC
• Summit Holistic Center LLC
• Kayla Sumpter
• Franklin Sun
• Tzu Chuan Sun
• Wenjie Sun, M.D.
• Sunbeam Care Rehab Services LLC

• Multi-Specialty Clinic/Center in Columbia, MD
• Providers in Columbia, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.