Individual provider Active NPI

Rachelle Lynette Summerhill

  • Clinical Social Worker
  • Tullahoma, TN
National Provider Identifier
1073844528
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8882 Issued in TN
Practice address
709 Davidson St
Tullahoma, TN 37388-3607
Phone
(931) 393-5917
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8882 TN Primary

Addresses

Primary practice location

709 Davidson St
Tullahoma, TN 37388-3607

Mailing address

709 Davidson St
Tullahoma, TN 37388-3607

Other practice location 1

416 S Main St
Estill Springs, TN 37330-4037
Phone (888) 291-4357

Other names 1

  • Rachelle Lynette Long Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809002989 TN Practitioner - Clinical Social Worker 7911445846 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

416 S Main St
Estill Springs, TN 37330
Phone (931) 205-3398

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

709 Davidson St
Tullahoma, TN 37388
Phone (931) 393-2126

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1073844528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 DAVIDSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 DAVIDSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373883607",
            "telephone_number": "931-393-5917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 S Main St",
            "address_purpose": "LOCATION",
            "city": "Estill Springs",
            "state": "TN",
            "postal_code": "373304037",
            "country_code": "US",
            "telephone_number": "888-291-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERHILL",
        "first_name": "RACHELLE",
        "middle_name": "LYNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "8882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "LONG",
            "middle_name": "LYNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.