Katharine Fannon Summerlin, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA40605 Issued in FL

Practice address

1304 E 6TH Ave
Tallahassee, FL 32303-6506

Phone

(850) 508-4612

Fax

(850) 656-5589

NPI assigned

Feb 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1265601082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 TWIN LAKES CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323114195",
            "telephone_number": "850-508-4612",
            "fax_number": "850-656-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 E 6TH AVE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036506",
            "telephone_number": "850-508-4612",
            "fax_number": "850-656-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "KATHARINE",
        "middle_name": "FANNON",
        "name_prefix": "Ms.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA40605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS / BLUESHIELD",
            "identifier": "C3746",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda M Sullivan, DSN, RN, ARNP
• Martha Elaine Sullivan, LMHC
• Ryan Esley Sullivan, LMT
• Beegam Sulthana
• Nina Renee Sumlar, MD
• Laura Cassels Summerlin
• Brent Summers, PA-C
• Sierra Michele Summers
• Sarah Rebecca Summy, CCC-SLP
• Dixie Sumner, APRN

• Massage Therapist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.