NPIMap

Organization Active NPI

Summerville Fitness LLC

  • Physical Therapy Clinic/Center
  • West Seneca, NY
National Provider Identifier
1366805848
Registry record updated Jun 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
015127-1 Issued in NY
Legal business name
SUMMERVILLE FITNESS LLC
Practice address
1900 Ridge Rd Ste 127
West Seneca, NY 14224-3332
Phone
(716) 677-2969
Fax
(716) 674-2969
NPI assigned
Apr 1, 2016
Last updated
Jun 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2016

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

Authorized official

Name
Mrs. Christina Nichole Summerville, P.T.NPI 1538420955
Title
Sole Provider
Phone
(716) 472-0652

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
Physical Therapy Clinic/Center 261QP2000X 015127-1 NY Primary

Addresses

Primary practice location

1900 Ridge Rd Ste 127
West Seneca, NY 14224-3332

Mailing address

25 Worthington LN
Lancaster, NY 14086-9391
Phone (716) 472-0652

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464998400000",
    "number": "1366805848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WORTHINGTON LN",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140869391",
            "telephone_number": "716-472-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RIDGE RD STE 127",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243332",
            "telephone_number": "716-677-2969",
            "fax_number": "716-674-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-06-04",
        "status": "A",
        "authorized_official_last_name": "SUMMERVILLE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "SOLE PROVIDER",
        "authorized_official_telephone_number": "716-472-0652",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "015127-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2016; 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.