Individual provider Active NPI

Summer Nicholson

  • Physical Therapist
  • Jbsa Lackland, TX
National Provider Identifier
1255179628
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1397582 Issued in TX
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-6255
Fax
(210) 292-7934
NPI assigned
Jul 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1397582 TX Primary
Physical Therapist 225100000X

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-6255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919001035 TX Practitioner - Physical Therapist in Private Practice 1153862099 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4700 Seton Ctr Pkwy
Suite 115
Austin, TX 78759-5753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1397582TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Aug 13, 2024 Accepting new patients
Texas Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 29, 2025 Accepting new patients
Ortholonestar, PLLC CurrentSince Aug 13, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Apr 28, 2025 Accepting new patients
Baylor College of Medicine CurrentSince Apr 28, 2025 Accepting new patients
Whasc PastSince Dec 29, 2024 Accepting new patients

Locations

4700 Seton Center Pkwy
Ste 115
Austin, TX 78759
Phone (346) 440-0644

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

22485 Tomball Pkwy
Ste 2100
Houston, TX 77070
Phone (281) 664-2107

10425 Huffmeister Rd
Ste 320
Houston, TX 77065
Phone (281) 955-2650

11800 FM 1960 Rd W
Houston, TX 77065
Phone (281) 664-2102

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

601 Rockmead Dr
Ste 100
Kingwood, TX 77339
Phone (281) 359-5115

180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066

11520 Northpointe Blvd
Tomball, TX 77377
Phone (281) 955-2650

Interoperability endpoints

  • Direct secure messaging: summer.nicholson.1@15533.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1255179628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255",
            "fax_number": "210-292-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-6255",
            "fax_number": "210-292-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SUMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1397582",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.