John William Summerville, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0101041829 Issued in VA

Practice address

200 Medical Park Blvd
Petersburg, VA 23805

Phone

(615) 221-4400

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

76.55 of 100Reported as group

Quality

72.42

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Pathologists LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1124075635
  NPD (past)

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1982604120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277542",
            "telephone_number": "615-221-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23805",
            "telephone_number": "615-221-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "VA",
            "postal_code": "238059274",
            "country_code": "US",
            "telephone_number": "804-765-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "VA",
            "postal_code": "238059274",
            "country_code": "US",
            "telephone_number": "804-765-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERVILLE",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101041829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006603858",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl W Stuart, CRNA
• Holly Ann Sturdevant
• Ann Wade Sublette, CRNA
• Jack Lee Suddreth, CRNA
• Nishanth Sukumaran, MD
• Supportive Care, Inc.
• Supportive Solution LLC
• Supportive Therapeutic Options, LLC
• Jennifer Lynn Sutherland, PHD
• Samantha Angelica Sweitzer, FNP-C

• Anatomic Pathology & Clinical Pathology Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.