Nicole Summerlin, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2919 Issued in NC

Practice address

225 White St
Jacksonville, NC 28546-6351

Phone

(910) 353-7222

NPI assigned

Jul 3, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1043473648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 STOKES GOODING ROAD",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "28349",
            "telephone_number": "910-296-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WHITE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466351",
            "telephone_number": "910-353-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "2919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericka Lee Sullivan-Gamble, LCSW-A
• Brianna Hohman Sullivan, DPT
• Kimberly Jarman Sullivan, R.PH.
• Bridget Sultzer
• Mary Ann Summerlin, LPCA
• Suncoast Medical, PC
• Tyra Sundquist, RN
• Katherine Price Sutherland, FNP-C
• Justin Sutton Sutton, IDC
• Edward Swailes, P.A.

• Physical Therapy Assistant in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.