Active NPI
Kimberly Sumner
- Mental Health Counselor
- Fort Myers, FL
National Provider Identifier
1114293479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2180 Maravilla LN
Fort Myers, FL 33901-7221 - Phone
- (239) 332-8009
- NPI assigned
- Mar 30, 2012
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2180 Maravilla LN
Fort Myers, FL 33901-7221
Mailing address
2180 Maravilla LN
Fort Myers, FL 33901-7221
Phone (239) 332-8009
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063528560 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333065600000",
"number": "1114293479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2180 MARAVILLA LN",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339017221",
"telephone_number": "239-332-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 MARAVILLA LN",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339017221",
"telephone_number": "239-332-8009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMNER",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-30",
"last_updated": "2012-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063528560",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.