SUMMIT SKIN CARE INCORPORATED (NPI# 1902099500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902099500 |
| Entity Type | Organization |
| Organization Name | SUMMIT SKIN CARE INCORPORATED |
| Other Organization Name | SUMMIT SKIN AND VEIN CARE |
| Practice Address |
3521 Ne Ralph Powell Rd Ste C Lees Summit MO 64064-2324 |
| Practice Telephone | 8165548346 |
| Practice Fax Number | 8165549470 |
| Mailing Telephone | 8165548346 |
| Mailing Fax Number | 8165549470 |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2019-09-04 |
| Authorized Official Name | DR. BRUCE EDWARD FEARON (PRESIDENT) |
| Authorized Official Telephone | 8165547546 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 102868 | MO | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Summit Skin and Vein Care | Doing Business As Name - Organization |
| Street Address |
3521 NE RALPH POWELL RD STE C |
| City | LEES SUMMIT |
| State | MO |
| Zip Code | 64064-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647704 | James Andrew Kleoppel | Dentist | 3320 Ne Ralph Powell Rd., Lee's Summit, MO 64064 | 2020-07-30 |
| 1255991238 | Lee Summit Asc Kc LLC | Clinic/Center | 2861 Ne Independence Avenue, Suite 101, Lee's Summitt, MO 64064 | 2019-06-20 |
| 1073014676 | Sonya Renee Aversman | Dietitian, Registered | 3680 Ne Akin Dr, Suite 134, Lee's Summit, MO 64064 | 2018-02-28 |
| 1407398365 | Lakewood Chiropractic, P.C. | Chiropractor | 731 Ne Lakewood Boulevard, Lee's Summit, MO 64064 | 2016-11-09 |
| 1417403015 | Mikaela Groff | Dietitian, Registered | 401 Ne Grant Ct, Lee's Summit, MO 64064 | 2016-09-01 |
| 1952756405 | Sarah C. Vignery | Speech-Language Pathologist | 3600 Ne Ralph Powell Rd. Suite E, Lee's Summit, MO 64064 | 2016-05-03 |
| 1790146058 | Aneliya H Hristova | Physician Assistant | 3601 Ne Ralph Powell Road., Lee's Summit, MO 64064 | 2016-03-15 |
| 1821469982 | Alysse Barrett Doane | Nurse Practitioner | 2714 Ne Mcbaine Drive, Lees Summit, MO 64064 | 2015-10-15 |
| 1346638814 | Donna Thomas Dds, PC | Dentist | 3359 Ne Ralph Powell Rd, Lee's Summit, MO 64064 | 2015-01-06 |
| 1437579208 | Gregory Lohr | Dentist | 2931 Ne Independence Ave, Lees Summit, MO 64064 | 2014-04-21 |
| Find all providers in zip 64064 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932444924 | Charles William Johnson | Family Medicine | 106 Ne Wood Glen Ln, Lees Summit, MO 64064-1508 | 2012-12-03 |
| 1174834360 | Craig Steven Ostrander | Family Medicine | 517 Se 2nd St Ste A, Lees Summit, MO 64063-2629 | 2010-06-23 |
| 1265605331 | Kelly Anne O'brien | Family Medicine | 600 Nw Murray Rd Ste 210, Lees Summit, MO 64081-1245 | 2008-04-09 |
| 1467583393 | Carl Spencer Davis | Family Medicine | 801 Ne Anderson Ln, Lees Summit, MO 64064-1244 | 2007-03-09 |
| 1013019579 | John William Klema IIi | Family Medicine | 4963 Ne Goodview Cir Ste B, Lees Summit, MO 64064-2491 | 2006-09-03 |
| 1619088879 | Ramon L Nichols | Family Medicine | 2741 Ne Mcbaine Dr, Lees Summit, MO 64064-7880 | 2006-08-31 |
| 1912015389 | Joy Eleanor Cuezze | Family Medicine | 3066 Grandstand Circle, Lees Summit, MO 64081 | 2006-08-27 |
| 1699718338 | Summit Medical Associates LLC | Family Medicine | 450 Ne M-291 Hwy, Lees Summit, MO 64086 | 2006-06-13 |
| 1871540658 | Family Health Specialist of Lee's Summit, LLC | Family Medicine | 2000 Se Blue Parkway, Suite 270 B, Lees Summit, MO 64063-4466 | 2006-05-27 |
| 1770538936 | Michelle Rene Britton-mehlisch | Family Medicine | 1301 A Arborwalk Blvd, Lees Summit, MO 64082 | 2006-05-24 |
| Find all providers in LEES SUMMIT | ||||
| City | LEES SUMMIT |
| Zip Code | 64064 |
Please comment or provide details below to improve the information on SUMMIT SKIN CARE INCORPORATED.
| 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.