Mackenzie Rae Summers, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2395 Issued in WV

Practice address

1543 Country Club Rd
Fairmont, WV 26554-1306

Phone

(304) 363-2273

NPI assigned

Sep 6, 2023

Last updated

Sep 6, 2023By 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 1

Addresses

Other names 1

• Kenzie Rae Summers Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1154107944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 VALLEY VIEW AVE APT B8",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053516",
            "telephone_number": "304-494-1792",
            "fax_number": "304-494-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 COUNTRY CLUB RD",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541306",
            "telephone_number": "304-363-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MACKENZIE",
        "middle_name": "RAE",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "2395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENZIE",
            "last_name": "SUMMERS",
            "middle_name": "RAE",
            "credential": "MOTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Neva Stuck
• Donna Sturgeon
• Cinthia Nedys Sturtevant
• Andrew Nicholas Summers, LGSW
• Britney Summers
• Travis Ray Summers
• Trina Elsey Summers
• Jeremy Scott Sutherland, B.A.
• Kristen Swearingen
• Harry Swift

• Occupational Therapist in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Occupational Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.