Healthcare Provider Details

I. General information

NPI: 1922517200
Provider Name (Legal Business Name): SUMMIT FAMILY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2017
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4031 NE LAKEWOOD WAY STE 100
LEES SUMMIT MO
64064-1703
US

IV. Provider business mailing address

4031 NE LAKEWOOD WAY STE 100
LEES SUMMIT MO
64064-1703
US

V. Phone/Fax

Practice location:
  • Phone: 816-944-3761
  • Fax: 816-272-2823
Mailing address:
  • Phone: 816-944-3761
  • Fax: 816-272-2823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CRAIG STEVEN OSTRANDER
Title or Position: MANAGING PHYSICIAN AND CEO
Credential: DO, MBA
Phone: 816-944-3761