Provider Demographics
NPI:1679595854
Name:SUMMY, CHAD ARRON (DPM)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ARRON
Last Name:SUMMY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1226 N WASHINGTON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3107
Mailing Address - Country:US
Mailing Address - Phone:402-391-7575
Mailing Address - Fax:402-391-1508
Practice Address - Street 1:9006 OHIO ST STE 1
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6139
Practice Address - Country:US
Practice Address - Phone:402-391-7575
Practice Address - Fax:402-391-1508
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE289213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100251280-00Medicaid
NE100251280-00Medicaid
NE277909Medicare ID - Type Unspecified
NENA1914Medicare PIN
NE1427348838OtherGROUP NPI: NEBRAKSA LOWER EXTREMITY SURGERY GROUP, LLC
NEU94470Medicare UPIN
NE100251280-00Medicaid
NE5275540001Medicare NSC
NENA1914004Medicare PIN