Individual provider Active NPI

Summer Thompson, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Vacaville, CA
National Provider Identifier
1114471844
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95004657 Issued in CA
Practice address
770 Mason St Ste 120
Vacaville, CA 95688-4648
Phone
(707) 741-3037
Fax
(707) 451-2324
NPI assigned
Aug 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95004657 CA Primary

Addresses

Primary practice location

770 Mason St Ste 120
Vacaville, CA 95688-4648

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (916) 576-7900

Other practice location 1

1141 Pear Tree Ln
Napa, CA 94558-6484
Phone (707) 254-1770

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95004657CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine M.D. Professional Corporation Psychiatric/Mental Health Past Accepting new patients

Organizations & group practices 1

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1114471844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900",
            "fax_number": "916-285-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MASON ST STE 120",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884648",
            "telephone_number": "707-741-3037",
            "fax_number": "707-451-2324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1141 Pear Tree Ln",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945586484",
            "country_code": "US",
            "telephone_number": "707-254-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SUMMER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95004657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.