NPIMap

Organization Active NPI

Summit Physical Therapy, Inc.

  • Physical Therapist
  • Homer, AK
National Provider Identifier
1487157665
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1069770 Issued in AK
Legal business name
SUMMIT PHYSICAL THERAPY, INC.
Practice address
601 E Pioneer Ave Ste 218
Homer, AK 99603
Phone
(907) 235-7473
Fax
(907) 205-5370
NPI assigned
Mar 14, 2018
Last updated
Jun 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Christina De la Torre, PT, DPTNPI 1336516772
Title
Chief Financial Officer & Treasurer
Phone
(907) 235-7473

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1069770 AK Primary

Addresses

Primary practice location

601 E Pioneer Ave Ste 218
Homer, AK 99603

Mailing address

PO Box 71
Homer, AK 99603-0071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180515001698 AK Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597029793 Receives reassigned benefits from 16 practitioners
Practice locations: Seldovia, AK; Homer, AK

National Provider Directory

National Provider Directory

Locations

601 E Pioneer Ave
Ste 218
Homer, AK 99603
Phone (907) 235-7473

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1487157665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996030071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E PIONEER AVE STE 218",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "99603",
            "telephone_number": "907-235-7473",
            "fax_number": "907-205-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "DE LA TORRE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER & TREASURER",
        "authorized_official_telephone_number": "907-235-7473",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1069770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.