NPIMap

Organization Active NPI

Summit Physical Therapy, PLLC

  • Physical Therapist
  • Orange Park, FL
National Provider Identifier
1225817695
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SUMMIT PHYSICAL THERAPY, PLLC
Practice address
2140 Kingsley Ave
Orange Park, FL 32073-5180
Phone
(904) 644-7722
NPI assigned
Sep 26, 2023
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Tara Reeves VollertsenNPI 1144363680
Title
Owner
Phone
(904) 644-7722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU Primary
Massage Therapist 225700000X NU

Addresses

Primary practice location

2140 Kingsley Ave
Orange Park, FL 32073-5180

Mailing address

2140 Kingsley Ave
Orange Park, FL 32073-5180
Phone (904) 644-7722

National Provider Directory

National Provider Directory
Tax ID family
Summit Physical Therapy PLL5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1225817695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-644-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735180",
            "telephone_number": "904-644-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "VOLLERTSEN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "REEVES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-644-7722"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.