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SUMMERS PHARMACY 13 INC
NPI 1417614702
Pharmacy - Community/Retail Pharmacy in Sedalia, MO

Active since November 21, 2021CLIA 26D2255359 · Waiver
1020 THOMPSON BLVD STE 100, SEDALIA, MO 65301(660) 851-0717(660) 310-3170 Get Directions Write a Review

NPPES record last updated: March 26, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 26, 2025, Feb 9, 2022, Dec 27, 2021 and 2 more (5 updates tracked since 2021).

About Summers Pharmacy 13 Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMERS PHARMACY 13 INC (NPI 1417614702) is a healthcare organization registered as a community/retail pharmacy in Sedalia, Missouri and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through March 13, 2028 and lists Ryan Summers, President, as its authorized official.

NPPES Registry Identity

NPI1417614702
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSUMMERS PHARMACY 13 INC
Location Address1020 THOMPSON BLVD STE 100Sedalia, MO 65301-2243
Mailing Address605 Pawnee StClinton, MO 64735-2757 · (660) 851-0717 · Fax (660) 310-3170
Phone(660) 851-0717
Fax(660) 310-3170
Organization SubpartYesParent: Summers Pharmacy Enterprises, Corp
Authorized OfficialRyan SummersPresident · (660) 351-0602
Enumeration DateNovember 21, 2021
Last NPPES UpdateMarch 26, 20255 updates tracked since enumeration
NPPES CertifiedMarch 26, 2025
✔ NPI 1417614702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
1020 THOMPSON BLVD STE 100, Sedalia, MO 65301
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Other Identifiers 1

Medicaid600105307MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summers Pharmacy 13 Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMissouriEnrollment IDO20220318000385Non-DME Part B · PharmacyDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2255359

Summers Pharmacy #13 · Sedalia, MO
Active · expires Mar 13, 2028
CLIA Number26D2255359
Laboratory TypePharmacy
Certificate Effective DateMarch 14, 2026
Certificate Expiration DateMarch 13, 2028
Laboratory DirectorRyan Summers
Laboratory Phone(660) 851-0717
Laboratory LocationSummers Pharmacy #131020 Thompson Blvd, Ste 100, Sedalia, MO 65301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
177 services177 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
150 services150 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
20 services20 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Summers Pharmacy carries, from the Medicare DMEPOS supplier directory.

Summers Pharmacy

DMEPOS supplier · Sedalia, MOOperated by Summers Pharmacy 13, Inc
✔

Accepts Medicare assignment

Summers Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20682395
Medicare Participant SinceJanuary 28, 2022
Supplier Location3400 W Broadway Blvd Ste ASedalia, MO 65301
Phone(660) 851-0717
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summers Pharmacy 13 Inc's NPI number?

The NPI number for Summers Pharmacy 13 Inc is 1417614702. It was assigned to this organization in the NPPES registry on November 21, 2021.

Where is Summers Pharmacy 13 Inc located?

Summers Pharmacy 13 Inc is located at 1020 Thompson Blvd Ste 100, Sedalia, MO 65301. The listed phone number is (660) 851-0717.

What is Summers Pharmacy 13 Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Summers Pharmacy 13 Inc enrolled in Medicare?

Yes. Summers Pharmacy 13 Inc is registered in the Medicare PECOS enrollment system.

When is Summers Pharmacy 13 Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Missouri, Pharmacy) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Summers Pharmacy 13 Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Summers Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Summers Pharmacy 13 Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2255359) is associated with this NPI, valid through March 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Summers Pharmacy 13 Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 44 other insurers list Summers Pharmacy 13 Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Summers Pharmacy 13 Inc was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.