| Summit Geriatrics Llc | |
|
200 Ne Missouri Rd Ste 200 Lees Summit MO 64086-4722 | |
| (913) 271-8676 | |
| (888) 856-3199 |
| Full Name | Summit Geriatrics Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 200 Ne Missouri Rd Ste 200, Lees Summit, Missouri |
| Authorized Official Name and Position | Shyam K. Akkulugari (CEO/SOLE OWNER) |
| Authorized Official Contact | 9132718676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Geriatrics Llc Po Box 7612 Overland Park KS 66207-0612 Ph: (913) 271-8676 | Summit Geriatrics Llc 200 Ne Missouri Rd Ste 200 Lees Summit MO 64086-4722 Ph: (913) 271-8676 |
| NPI Number | 1073745493 |
|---|---|
| Provider Enumeration Date | 08/18/2009 |
| Last Update Date | 12/07/2020 |
| Medicare PECOS PAC ID | 8325194277 |
|---|---|
| Medicare Enrollment ID | O20090918000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073745493 | NPI | - | NPPES |
| Provider Name | Shyam K Akkulugari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326031006 PECOS PAC ID: 3870536402 Enrollment ID: I20061101000415 |
| Provider Name | Lance A Vickery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801101613 PECOS PAC ID: 7517156094 Enrollment ID: I20121023000549 |
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