Active NPI
Rebecca Summerer, OTR/L
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1225324494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6555
- Practice address
- 6774 Vlosi Dr
Charlotte, NC 28226-4029 - Phone
- (701) 403-9413
- NPI assigned
- Jun 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 6555 | NC | Primary |
Addresses
Primary practice location
6774 Vlosi Dr
Charlotte, NC 28226-4029
Mailing address
6774 Vlosi Dr
Charlotte, NC 28226-4029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TH2698 | Medicaid | SC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6555 | NC | MD | Mental Health Counselor |
| 1400 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Balance Dietitian, LLC | 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.
-
- Registered Dietitian
- Fargo, ND
- NPI 1255190534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400457600000",
"number": "1225324494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6774 VLOSI DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282264029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6774 VLOSI DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282264029",
"telephone_number": "701-403-9413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERER",
"first_name": "REBECCA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-25",
"last_updated": "2014-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "6555",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH2698",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.