Summit Primary Care PLLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

SUMMIT PRIMARY CARE PLLC

Practice address

13564 Village Park Dr Unit O-355
Orlando, FL 32837-7760

Phone

(407) 974-4056

Fax

(407) 550-7844

NPI assigned

Jul 29, 2025

Last updated

Oct 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gracemarie Rosario Walls, PA-CNPI 1356766620

Title

Owner

Phone

(321) 496-5717

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Gracemarie Rosario Walls, PA-C

  • Physician Assistant
  • Orlando, FL
  • NPI 1356766620
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1753747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761350400000",
    "number": "1548143274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13564 VILLAGE PARK DR UNIT O-355",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13564 VILLAGE PARK DR UNIT O-355",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377760",
            "telephone_number": "407-974-4056",
            "fax_number": "407-550-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-10-25",
        "certification_date": "2025-10-25",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "GRACEMARIE",
        "authorized_official_middle_name": "ROSARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-496-5717",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Summerlin, ATC
• Kimberly Summers
• Laura B Summers, M.D.
• Natalee Rhodes Summers
• Summit Chiropractic, LLC (Summit Chiropractic)
• Summit Psychological Services PA
• Kalie Sumple, MS
• Grace Arojado Sumulong, ARNP
• Sun Health and Wellness, Inc (Family Care Pharmacy Chickasaw)
• Sun State Physicians Services, LLC

• Medical Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.