Summit Rehabilitation LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2570 Issued in NM

Legal business name

SUMMIT REHABILITATION LLC

Practice address

722 E Florida St
Deming, NM 88030-5310

Phone

(505) 546-2555

Fax

(505) 546-2725

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Marie Stevens, MSPTNPI 1497844732

Title

Physical Therapist/Managing Partner

Phone

(505) 546-2555

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Marie Stevens, M. S. P. T.

  • Physical Therapist
  • Deming, NM
  • NPI 1497844732
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley N Fetrow, DPT

  • Physical Therapist
  • Deming, NM
  • NPI 1609267194
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1477542041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E FLORIDA ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880305310",
            "telephone_number": "505-546-2555",
            "fax_number": "505-546-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E FLORIDA ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880305310",
            "telephone_number": "505-546-2555",
            "fax_number": "505-546-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/MANAGING PARTNER",
        "authorized_official_telephone_number": "505-546-2555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "104461700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRES",
            "identifier": "73559",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00079902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LVLC",
            "identifier": "23693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57831271",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NMO1Q136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Dianne Stephens, LPCC
• Stevens Chiropractic Center LLC
• Shannon Marie Stevens, M. S. P. T.
• Mickie Lynn Stimpson, LBSW
• Summit Healthcare LLC
• Summits Healthcare, LLC
• Catherine L Tanner
• Tasker Hatch Rowan LLC
• Edward Teague
• The Eye Place Corporation

• Physical Therapist in Deming, NM
• Providers in Deming, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.