Active NPI
Summer Rose Wilson, MS, ATC, LAT
- Athletic Trainer
- New Orleans, LA
National Provider Identifier
1033343942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- ATH.200277
- Practice address
- 1713 Alvar St
New Orleans, LA 70117-5128 - Phone
- (512) 636-6989
- NPI assigned
- May 6, 2009
- Last updated
- Oct 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | ATH.200277 | LA | Primary |
Addresses
Primary practice location
1713 Alvar St
New Orleans, LA 70117-5128
Mailing address
1713 Alvar St
New Orleans, LA 70117-5128
Phone (512) 636-6989
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ATH.200277 | LA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1033343942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 ALVAR ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701175128",
"telephone_number": "512-636-6989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1713 ALVAR ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701175128",
"telephone_number": "512-636-6989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SUMMER",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "MS, ATC, LAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-06",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "LA",
"license": "ATH.200277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.