Jevene Marie Summers, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305202400 Issued in VA

Practice address

3260 Wilson Blvd Ste 21E
Arlington, VA 22201-4423

Phone

(703) 963-5695

NPI assigned

Nov 19, 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)

Enrolled

Practice roles

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.

• Virginia Pediatric and Adolescent Medicine

  • Pediatrics Physician
  • Arlington, VA
  • NPI 1376733782
  NPD (past)

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1306091210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 9TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111115",
            "telephone_number": "703-328-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 WILSON BLVD STE 21E",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222014423",
            "telephone_number": "703-963-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JEVENE",
        "middle_name": "MARIE",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA STATE BOARD PHYSICAL THERAPY LICENSE",
            "identifier": "2305202400",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucy Mackinnon Sullivan
• Mark Ford Sullivan, M.D.
• Michele Martin Sullivan, RN
• Zain Jalal Sultan, MD
• Kevin D Sumida, MD
• Summit Counseling LLC
• Stephanie Virginia Sun, MD
• Annie Sung
• Chao-Hui Sung, L.C.S.W.
• Jin Sook Sung, PHARMD

• Physical Therapist in Arlington, VA
• Providers in Arlington, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.