Individual provider Active NPI

Cailey Lynn Summers, PTA

  • Physical Therapy Assistant
  • Marion, IA
National Provider Identifier
1205596285
Registry record updated Dec 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
105401 Issued in IA
Practice address
3456 Indian Creek Rd
Marion, IA 52302-1119
Phone
(319) 377-8296
NPI assigned
Dec 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 105401 IA Primary

Addresses

Primary practice location

3456 Indian Creek Rd
Marion, IA 52302-1119

Mailing address

5306 Mayfair St SW
Cedar Rapids, IA 52404-7159

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

State licenses

LicenseStateTypeSpecialty
105401IAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1639785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639785600000",
    "number": "1205596285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 MAYFAIR ST SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524047159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 INDIAN CREEK RD",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523021119",
            "telephone_number": "319-377-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "CAILEY",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-18",
        "last_updated": "2021-12-18",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "105401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2021; 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.