SUMMIT MEDICAL GROUP, INC (NPI# 1164995544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164995544 |
| Entity Type | Organization |
| Organization Name | SUMMIT MEDICAL GROUP, INC |
| Other Organization Name | ST. ELIZABETH PHYSICIANS |
| Practice Address |
1400 Grand Avenue Newport KY 41071 |
| Mailing Address |
1360 Dolwick Drive Erianger KY 41018 |
| Practice Telephone | 8597572132 |
| Practice Fax Number | 8594410765 |
| Mailing Telephone | 8593445555 |
| Mailing Fax Number | 8593445552 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | MARIA RANKIN (AVP REVENUE CYCLE) |
| Authorized Official Telephone | 8593445555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Elizabeth Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396398624 | Summit Medical Group, Inc | Family Medicine | 79 Country Club Drive, Butler, KY 41006-8704 | 2019-07-16 |
| 1174096580 | Summit Medical Group, Inc | Clinic/Center | 8726 Us Highway 42, Florence, KY 41042-8550 | 2019-01-08 |
| 1922574854 | Summit Medical Group, Inc | Clinic/Center | 351 Centre View Boulevard, Crestview Hills, KY 41017-3477 | 2018-10-18 |
| 1639586688 | Summit Medical Group, Inc | Urology | 7370 Turfway Rd, 3rd Floor, Florence, KY 41042-4895 | 2014-07-22 |
| 1548677636 | Summit Medical Group, Inc | Podiatrist | 525 Alexandria Pike, Ste 230, Southgate, KY 41071-3290 | 2014-07-21 |
| 1508287640 | Summit Medical Group, Inc | Counselor | 1360 Dolwick Drive, Erlanger, KY 41018-3127 | 2013-12-16 |
| 1083035299 | Summit Medical Group, Inc | Emergency Medicine | 2091 N Bend Rd, Hebron, KY 41048-9691 | 2013-12-16 |
| 1578984779 | Summit Medical Group, Inc | Emergency Medicine | 4387 Winston Ave, Covington, KY 41015-1739 | 2013-12-16 |
| 1790042430 | Summit Medical Group, Inc | Clinic/Center | 2626 Alexandria Pike, Highland Heights, KY 41076-1530 | 2012-04-19 |
| 1750343216 | Summit Medical Group, Inc | Counselor | 1360 Dolwick Drive, Erlanger, KY 41018-3127 | 2006-04-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | SUMMIT MEDICAL GROUP, INC. | 334 Thomas More Pkwy, Ste 160, Edgewood, KY 41017 |
| Street Address |
1400 GRAND AVENUE |
| City | NEWPORT |
| State | KY |
| Zip Code | 41071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730306754 | Benjamin Michael Anderson | Psychologist | 1400 Grand Avenue, Newport, KY 41071 | 2007-04-19 |
| 1548733066 | Summt Medical Group, Inc | Clinic/Center | 1400 Grand Avenue, Newport, KY 41071 | 2019-01-08 |
| 1093137812 | Summit Medical Group, Inc. | Emergency Medicine | 1400 Grand Avenue, Newport, KY 41071-2570 | 2014-01-14 |
| 1932442175 | Darek Sanford | Internal Medicine | 1400 Grand Avenue, Newport, KY 41071-2570 | 2013-04-05 |
| 1457663833 | Tyler William Browning | Family Medicine | 1400 Grand Avenue, St Elizabeth Physicians, Newport, KY 41071 | 2010-07-13 |
| 1093976375 | Sherri Lynne Schwartz | Family Medicine | 1400 Grand Avenue, St Elizabeth Physicians, Newport, KY 41071-2570 | 2008-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528598240 | Drew Austin Rappaport | Dentist | 70 Carothers Rd, Newport, KY 41071 | 2017-06-14 |
| 1811443435 | Marcus E. Mckinney | Pharmacist | 100 Aqua Way, Newport, KY 41071 | 2016-09-01 |
| 1437288065 | Douglas K Braun | Dentist | 40 E 9th St, Newport, KY 41071 | 2007-03-02 |
| 1952445017 | Therapeutic Collabortive | Social Worker | 525 Licking Pike, Wilder, KY 41071 | 2007-02-20 |
| 1215078407 | Holly Ann Eary | Counselor | 519 Licking Pk, Wilder, KY 41071 | 2007-02-09 |
| 1790839819 | James John Otrembiak | Pediatrics | 525 Alexandria Pike Ste 320, Southgate, KY 41071 | 2007-01-23 |
| 1326047903 | Stephen F Mielech | Podiatrist | 525 Alexandria Pike, Southgate, KY 41071 | 2005-07-18 |
| 1033737085 | Ashley Ryan | Nurse Practitioner | 215 E. 11th St., Newport, KY 41071 | 2020-07-07 |
| 1619454071 | Sarah Kaiser | Social Worker | 1 Moock Rd Ste 101, Wilder, KY 41071 | 2018-07-27 |
| 1750877023 | Alyssa Kreider | Nurse Practitioner | 1400 Grand Ave, Newport, KY 41071 | 2018-07-10 |
| Find all providers in zip 41071 | ||||
| Taxonomy Code | 207VF0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336300300 | Sonali Vora Raman | Obstetrics & Gynecology | 1400 Grand Ave, Newport, KY 41071-2570 | 2008-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205252426 | Susan B Tate Md Pa | Obstetrics & Gynecology | 2934 Breckenridge Ln, Suite 2, Louisville, KY 40220-3903 | 2014-03-12 |
| 1174839401 | Gerardo Manuel Heredia Melero | Obstetrics & Gynecology | Uk Obgyn, 125 E. Maxwell Street, Lexington, KY 40508 | 2010-08-24 |
| 1427470525 | University of Louisville Research Foundation Inc | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2014-01-09 |
| 1003182270 | Caroline Elmer-lyon | Obstetrics & Gynecology | 610 Medical Village Dr, Edgewood, KY 41017-3416 | 2012-03-31 |
| 1811913585 | Susan S.b. Tate | Obstetrics & Gynecology | 2934 Breckenridge Ln Ste 2, Louisville, KY 40220-3903 | 2006-07-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.