Hannah Souksavong, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39810 Issued in FL

Practice address

1305 N Orange Ave Ste 118
Green Cove Springs, FL 32043-2553

Phone

(904) 531-5500

NPI assigned

Oct 10, 2023

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

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

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1194506626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S TWIN MAPLE RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848372",
            "telephone_number": "615-707-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N ORANGE AVE STE 118",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320432553",
            "telephone_number": "904-531-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUKSAVONG",
        "first_name": "HANNAH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahriar a Nabizadeh MD PA
• Smiling Creations, PA
• Kayla Smith, FNP-BC
• Lawrence Matthew Smith, PHARMD
• Qiana Smith
• Thomas E Stakem, D.D.S.,M.D.
• Stephen B. Gill, M.D.,P.a.
• Hannah Mae Lynn Steward, RBT
• Kristina Stewart, M.A.
• April Rae Stone, D.M.D.

• Physical Therapist in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.