1. Home
  2. Directory
  3. Ohio
  4. Youngstown
  5. Local Education Agency Lea
  6. NPI Profile
  7. NPI Record 1104010602

SUMMIT ACADEMY YOUNGSTOWN
Complete NPI Record 1104010602
Local Education Agency (LEA) in Youngstown, OH

NPI Status: Active since August 29, 2007

Contact Information

2800 SHADY RUN ROAD
YOUNGSTOWN, OH
ZIP 44502
Phone: (330) 670-8470
Fax: (330) 743-9260

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Middle Name
  24. Authorized Official Title or Position
  25. Authorized Official Telephone Number
  26. Healthcare Provider Taxonomy Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Organization Subpart

Complete NPI Dataset

This page represents the complete record for NPI 1104010602. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1104010602
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 2800 SHADY RUN ROAD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: YOUNGSTOWN
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: OH
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 445026520
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3308366200
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider Business Mailing Address Fax Number: 3308368216
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Practice Location Address: 2800 SHADY RUN ROAD
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Practice Location Address City Name: YOUNGSTOWN
The first name of the provider, if the provider is an individual.
Provider Business Practice Location Address State Name: OH
The middle name of the provider, if the provider is an individual.
Provider Business Practice Location Address Postal Code: 445026520
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Practice Location Address Country Code If outside U S : US
The city name in the mailing address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3306708470
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Practice Location Address Fax Number: 3307439260
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Enumeration Date: 8/29/2007
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Last Update Date: 4/8/2024
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Authorized Official Last Name: HOSKIN
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Authorized Official First Name: DAVID
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Authorized Official Middle Name: M
The city name in the location address of the provider being identified.
Authorized Official Title or Position: TREASURER
The State code in the location of the provider being identified.
Authorized Official Telephone Number: 3306708470
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Healthcare Provider Taxonomy Code 1: 251300000X
The country code in the location address of the provider being identified.
Healthcare Provider Primary Taxonomy Switch 1: Y
The telephone number associated with the location address of the provider being identified.
Is Organization Subpart: N
The fax number associated with the location address of the provider being identified.