Organization Active NPI

Summa Physician LLC

  • Family Medicine Physician
  • Fairlawn, OH
National Provider Identifier
1972709699
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMA PHYSICIAN LLC
Doing business as
Summa Health Medical Group
Practice address
605 N Cleveland Massillon Rd Ste B
Fairlawn, OH 44333-2200
Phone
(330) 666-3333
Fax
(330) 668-6532
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Wendy Carson
Title
Manager, Payer Enrollment
Phone
(234) 312-5691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

605 N Cleveland Massillon Rd Ste B
Fairlawn, OH 44333-2200

Mailing address

1077 Gorge Blvd
Akron, OH 44310-2408
Phone (234) 312-5873

Other identifiers 1

IdentifierTypeStateIssuer
2778034MedicaidOH

Other names 1

  • Summa Health Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000295 OH Part B Supplier - Clinic/Group Practice 2961303532 Receives reassigned benefits from 729 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1972709699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 GORGE BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443102408",
            "telephone_number": "234-312-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N CLEVELAND MASSILLON RD STE B",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332200",
            "telephone_number": "330-666-3333",
            "fax_number": "330-668-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMA PHYSICIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MANAGER, PAYER ENROLLMENT",
        "authorized_official_telephone_number": "234-312-5691"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2778034",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summa Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.