NPIMap

Organization Active NPI

Summit Integrative Health, LLC

  • General Practice Physician
  • Jacksonville, FL
National Provider Identifier
1295202984
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SUMMIT INTEGRATIVE HEALTH, LLC
Practice address
12627 San Jose Blvd Ste 305
Jacksonville, FL 32223-8639
Phone
(904) 683-4376
Fax
(904) 683-4378
NPI assigned
Oct 31, 2018
Last updated
Oct 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Dr. Justin TinkerNPI 1194127670
Title
Owner
Phone
(404) 405-9168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

12627 San Jose Blvd Ste 305
Jacksonville, FL 32223-8639

Mailing address

12627 San Jose Blvd Ste 305
Jacksonville, FL 32223-8639
Phone (904) 683-4376

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1295202984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 SAN JOSE BLVD STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238639",
            "telephone_number": "904-683-4376",
            "fax_number": "904-683-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 SAN JOSE BLVD STE 305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238639",
            "telephone_number": "904-683-4376",
            "fax_number": "904-683-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT INTEGRATIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "TINKER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-405-9168",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.