Glenn Edsel Summers Jr., M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME60639 Issued in FL

Practice address

5153 N 9TH Ave
Suite 305
Pensacola, FL 32504-8785

Phone

(850) 416-6159

Fax

(850) 416-7198

NPI assigned

Oct 26, 2005

Last updated

Dec 30, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Miami, LM Miller School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Enterprise Clinic LLCGroup PAC ID 1456488667, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Dothan, AL, CCN 017053
• Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049
• Flowers Hospital Hospital, Dothan, AL, CCN 010055

Merit-based Incentive Payment System (MIPS)

Final score

87.97 of 100Reported as apm

Quality

75.95

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glenn.summers.1@2445.direct.athenahealth.com

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.

• Enterprise Clinic LLC

  • Family Medicine Physician
  • Enterprise, AL
  • NPI 1639491616
  Medicare reassignment Care Compare group NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1629374327

  AL

  Medicare reassignment NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1598061293
  NPD
• Southwest Georgia Surgical Associates, PC

  • Surgery Physician
  • Americus, GA
  • NPI 1609987262
  NPD (past)
• Sumter Regional Medical Group, PC

  • Specialist
  • Americus, GA
  • NPI 1073685996
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caresouth HHA Holdings of Dothan, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Dothan, AL
  • NPI 1770561268
  Care Compare affiliation
• QHG of Enterprise Inc

  dba Medical Center Enterprise

  • General Acute Care Hospital
  • Enterprise, AL
  • NPI 1720039712
  Care Compare affiliation
• Triad of Alabama LLC

  dba Flowers Hospital

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1982694378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-6159",
            "fax_number": "850-416-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 N 9TH AVE",
            "address_2": "SUITE 305",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048785",
            "telephone_number": "850-416-6159",
            "fax_number": "850-416-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "GLENN",
        "middle_name": "EDSEL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME60639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Sullivan, M.D.
• Kevin Sullivan, MOTR-L
• Raymond Sullivan, LMHC
• Joseph Bryan Summerford, RPH
• Andrew Summerlin, LAT, ATC
• Susan Janette Summerton, OD
• Summit Dermatology and Spa LLC
• Arthur Timothy Sumrall II, M. D.
• Sunil Gupta MD LLC (Retina Specialty Institute)
• Katherine J Sunnenberg, ARNP

• Surgery Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.
• 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.