Tara Reeves Vollertsen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30511 Issued in FL

Practice address

2219 County Road 220 Ste 304
Middleburg, FL 32068-7778

Phone

(360) 707-8107

NPI assigned

Feb 15, 2007

Last updated

May 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Physical Therapy, PLLCGroup PAC ID 7416384763, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Middleburg, FL
  • NPI 1992348569
  Medicare reassignment Care Compare group NPD Authorized official
• Genesis Health Development Inc

  dba Brooks Rehab Center/Low Vision

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1033154992
  Medicare reassignment NPD
• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Orange Park, FL
  • NPI 1225817695
  NPD (past) Authorized official
• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Orange Park, FL
  • NPI 1295591022
  NPD (past) Authorized official
• Summit Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Green Cove Springs, FL
  • NPI 1508548371
  NPD (past) Authorized official
• Summit Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Middleburg, FL
  • NPI 1992505945
  NPD (past) Authorized official
• Genesis Health Development, Inc.

  dba Brooks Health Development

  • Rehabilitation Clinic/Center
  • Clermont, FL
  • NPI 1528707379
  NPD

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1144363680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 COUNTY ROAD 220 STE 304",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687778",
            "telephone_number": "904-644-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 COUNTY ROAD 220 STE 304",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687778",
            "telephone_number": "360-707-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLERTSEN",
        "first_name": "TARA",
        "middle_name": "REEVES",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23181",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lauren Electa Wagner, PHARMD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3308)
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5820)
• Wal-Mart Stores East, LP (Vision Center 30-3308)

• Physical Therapist in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.