Individual provider Active NPI

Jason Summers, PT, DPT

  • Physical Therapist
  • Newnan, GA
National Provider Identifier
1073086625
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP035365T Issued in GA
Practice address
40 Greenway CT Ste B&C
Newnan, GA 30265-2326
Phone
(770) 502-0195
NPI assigned
Jan 7, 2019
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0016146 CO
Physical Therapist 225100000X CP035365T GA Primary

Addresses

Primary practice location

40 Greenway CT Ste B&C
Newnan, GA 30265-2326

Mailing address

40 Greenway CT Ste B&C
Newnan, GA 30265-2326
Phone (770) 502-0195

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 30, 2023 Accepting new patients
Altitude Physical Therapy & Sports Medicine LLC Physical Therapist CurrentSince Aug 29, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 30, 2023 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Altitude Physical Therapy & Sports Medicine LLC PastSince Jan 24, 2021 Accepting new patients
Runners Edge Alaska Physical Therapist Past Accepting new patients

Locations

933 Alpine Ave
Boulder, CO 80304
Phone (303) 444-0378

500 Eldorado Blvd
Bldg 4
Broomfield, CO 80021
Phone (303) 812-4790

275 S Main St
Ste 208
Longmont, CO 80501
Phone (303) 776-3800

7833 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-6534

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

40 Greenway Ct
Ste Bc
Newnan, GA 30265
Phone (770) 502-0195

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1073086625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 GREENWAY CT STE B&C",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652326",
            "telephone_number": "770-502-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GREENWAY CT STE B&C",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652326",
            "telephone_number": "770-502-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0016146",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP035365T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.