Individual provider Active NPI

Valarie Crisp Summerow, MSN, ANPBC

  • Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1275859282
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5004622 Issued in NC
Practice address
133 1St Ave SE
Hickory, NC 28602-3005
Phone
(828) 994-4544
Fax
(828) 624-0546
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5004622 NC Primary

Addresses

Primary practice location

133 1St Ave SE
Hickory, NC 28602-3005

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100614000566 NC Practitioner - Nurse Practitioner 0446380778 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5004622NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cabral Internal Medicine PLLC Internal Medicine CurrentSince Sep 12, 2016 Accepting new patients
Bowen Primary & Urgent Care PA Internal Medicine CurrentSince Dec 30, 2015 Accepting new patients
Springs Road Consulting LLC Internal Medicine Past Accepting new patients

Locations

711 Fairgrove Church Rd SE
Conover, NC 28613
Phone (828) 855-3636

116 3rd St NE
Ste 102
Hickory, NC 28601
Phone (828) 855-1192

116 3rd St NW
#102
Hickory, NC 28601
Phone (828) 855-1192

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2575/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1275859282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904",
            "fax_number": "704-867-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 1ST AVE SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286023005",
            "telephone_number": "828-994-4544",
            "fax_number": "828-624-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMEROW",
        "first_name": "VALARIE",
        "middle_name": "CRISP",
        "credential": "MSN, ANPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.