Active NPI
Summer Christian Teague
- Massage Therapist
- Jacksonville, FL
National Provider Identifier
1033671896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA91601
- Practice address
- 9765 San Jose Blvd Ste 106
Jacksonville, FL 32257-5467 - Phone
- (904) 551-5350
- Fax
- (904) 647-9650
- NPI assigned
- Apr 2, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA91601 | FL | Primary |
Addresses
Primary practice location
9765 San Jose Blvd Ste 106
Jacksonville, FL 32257-5467
Mailing address
9765 San Jose Blvd Ste 106
Jacksonville, FL 32257-5467
Phone (904) 551-5350
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA91601 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554163200000",
"number": "1033671896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9765 SAN JOSE BLVD STE 106",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322575467",
"telephone_number": "904-551-5350",
"fax_number": "904-647-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9765 SAN JOSE BLVD STE 106",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322575467",
"telephone_number": "904-551-5350",
"fax_number": "904-647-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAGUE",
"first_name": "SUMMER",
"middle_name": "CHRISTIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-02",
"last_updated": "2019-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA91601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
- TDN Dentistry, PLLC (Natural Teeth Implant Center)
- TDN Dentistry, PLLC (Jacksonville Emergency Dental - North, PLLC)
- Sandra Carol Teachey, A.P.
- Ashton Teague
- Cara Elizabeth Teague, OTR
- Daniel B Teahan, PT
- Vicki Teal, FNP
- Team Williams Limited Liability Company
- Teammd Physicians PC
- Abigail Louise Teano
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.