Organization Active NPI

Summit Performance and Physical Therapy

  • Physical Therapist
  • Brentwood, MO
National Provider Identifier
1508798018
Registry record updated May 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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

Updated by the provider on May 30, 2026

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

Authorized official

Name
Taylor Dettmann, DPT PTNPI 1710361357
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)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Practitioners & affiliated clinicians

Practitioners 1

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

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.

Verify at the official NPI Registry.