Miranda Renee Summers, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

022888-1 Issued in NY

Practice address

4602 Wynburne Ave
Erie, PA 16509-1703

Phone

(724) 854-0203

NPI assigned

Apr 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Capable Kids LLC

  • Occupational Therapist
  • Hermitage, PA
  • NPI 1386079200
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1508328592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 WYNBURNE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091703",
            "telephone_number": "724-854-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 WYNBURNE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091703",
            "telephone_number": "724-854-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MIRANDA",
        "middle_name": "RENEE",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022888-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Sulkowski, M.A.
• Charles Edward Sullivan, PHARMD
• Kathy M Sullivan, PA-C
• Nathan Sullivan, LSW
• Dalton Wade Summerhill
• Summit Dental Associates, P. C
• Summit Footwear, LLC
• Summit Psychiatric Associates PLLC
• Angel F Sunafrank, CRNP
• Kendall Sundberg

• Occupational Therapist in Erie, PA
• Providers in Erie, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.