SUMMIT RADIOLOGY SERVICES LLC (NPI# 1124044607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124044607 |
| Entity Type | Organization |
| Organization Name | SUMMIT RADIOLOGY SERVICES LLC |
| Practice Address |
3738 Landmark Dr. Suite D Lafayette IN 47905-6655 |
| Practice Telephone | 7654497984 |
| Practice Fax Number | 7654499791 |
| Mailing Telephone | 7654497984 |
| Mailing Fax Number | 7654499791 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2013-01-25 |
| Authorized Official Name | GLENN A TUCKMAN (PRESIDENT) |
| Authorized Official Telephone | 7654497984 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200020370B | 05 | |
| KY | MEDICAID | 64882822 | 01 |
| WI | MEDICAID | 31714000 | 01 |
| Street Address |
3738 LANDMARK DR. SUITE D |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-6655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588295448 | Hassan Sawaf | Radiology | 1411 S Creasy Ln Ste 130, Lafayette, IN 47905-7433 | 2020-01-30 |
| 1801383245 | St Marys Imaging Center II | Radiology | 4809 Ambassador Caffery Pkwy Ste 350, Lafayette, LA 70508-8801 | 2018-04-20 |
| 1578937744 | Modesto Radiological Medical Group | Radiology | 2283 Hidden Pond Ln, Lafayette, CA 94549-1742 | 2015-11-25 |
| 1629411210 | Lowell David Froker | Radiology | 32 Olympic Oaks Dr, Lafayette, CA 94549-4800 | 2013-04-12 |
| 1386987196 | Imaging Partners Medical Group | Radiology | 3976 Canyon Rd, Lafayette, CA 94549-2702 | 2013-03-29 |
| 1982946562 | Rachael Lane Guillory | Radiology | 1811 Dulles Dr, Lafayette, LA 70506-3724 | 2013-03-21 |
| 1578811386 | Maurice Louis Bercier | Radiology | 309 Steiner Road, Lafayette, LA 70508 | 2012-08-28 |
| 1295024222 | Lourdes Imaging Center LLC | Radiology | 4809 Ambassador Caffery Parkway, Suite 350, Lafayette, LA 70508 | 2011-03-30 |
| 1467784744 | Delano Zeus Arvin | Radiology | 6233 N 700 E, Lafayette, IN 47905-9761 | 2010-02-11 |
| 1003045287 | Professional Radiology Network Tlc-prn, LLC | Radiology | 107 Kempton Dr, Lafayette, LA 70508-6547 | 2009-07-08 |
| Find all providers in LAFAYETTE | ||||
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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.