Active NPI
Summer Dornon
- School Psychologist
- Rock Springs, WY
National Provider Identifier
1255085759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 77176
- Practice address
- 2225 Weatherby Ave
Rock Springs, WY 82901-6841 - Phone
- (312) 835-0675
- NPI assigned
- Feb 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 491353R | WA | |
| School Psychologist | 103TS0200X | 7024 | ID | |
| School Psychologist | 103TS0200X | 77176 | WY | Primary |
Addresses
Primary practice location
2225 Weatherby Ave
Rock Springs, WY 82901-6841
Mailing address
2225 Weatherby Ave
Rock Springs, WY 82901-6841
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7024 | ID | MD | School Psychologist |
| 491353R | WA | MD | School Psychologist |
| 77176 | WY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1255085759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 WEATHERBY AVE",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829016841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 WEATHERBY AVE",
"city": "ROCK SPRINGS",
"state": "WY",
"postal_code": "829016841",
"telephone_number": "312-835-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORNON",
"first_name": "SUMMER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": "WA",
"license": "491353R",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "ID",
"license": "7024",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WY",
"license": "77176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Springs, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.