Active NPI
Stephen Lynn Summers, DC
- Chiropractor
- Austin, TX
National Provider Identifier
1255456232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2770
- Practice address
- 3907 Medical Pkwy
Ste 102
Austin, TX 78756-4015 - Phone
- (512) 458-5880
- Fax
- (512) 444-1094
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2770 | TX | Primary |
Addresses
Primary practice location
3907 Medical Pkwy
Ste 102
Austin, TX 78756-4015
Mailing address
12701 Shemya CV
Austin, TX 78729-7733
Phone (512) 415-0828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 606282 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120613000443 | TX | Practitioner - Chiropractic | 6901060490 | Practice locations: Austin, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2770 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491955200000",
"number": "1255456232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12701 SHEMYA CV",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787297733",
"telephone_number": "512-415-0828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3907 MEDICAL PKWY",
"address_2": "STE 102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787564015",
"telephone_number": "512-458-5880",
"fax_number": "512-444-1094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "STEPHEN",
"middle_name": "LYNN",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2017-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "2770",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "606282",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.