Active NPI
Summit Performance and Physical Therapy
- Physical Therapist
- Brentwood, MO
National Provider Identifier
1508798018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- SUMMIT PERFORMANCE AND PHYSICAL THERAPY
- Practice address
- 567 Hanley Industrial CT
Brentwood, MO 63144-1901 - Phone
- (309) 231-0196
- NPI assigned
- May 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Taylor Dettmann, DPT PT
- Title
- Owner
- Phone
- (309) 231-0196
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
567 Hanley Industrial CT
Brentwood, MO 63144-1901
Mailing address
214 E Clinton PL
Saint Louis, MO 63122-6106
Phone (309) 231-0196
Other practice location 1
214 E Clinton Pl
Saint Louis, MO 63122-6106
Phone (309) 231-0196
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Brentwood, MO
- NPI 1710361357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780099200000",
"number": "1508798018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 E CLINTON PL",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631226106",
"telephone_number": "309-231-0196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "567 HANLEY INDUSTRIAL CT",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631441901",
"telephone_number": "309-231-0196"
}
],
"practiceLocations": [
{
"address_1": "214 E Clinton Pl",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631226106",
"country_code": "US",
"telephone_number": "309-231-0196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUMMIT PERFORMANCE AND PHYSICAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-30",
"last_updated": "2026-05-30",
"certification_date": "2026-05-30",
"status": "A",
"authorized_official_last_name": "DETTMANN",
"authorized_official_first_name": "TAYLOR",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "309-231-0196",
"authorized_official_credential": "DPT PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.