Carla Rosanne Summers, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

65167 Issued in TN

Practice address

920 University St
Martin, TN 38237-1605

Phone

(731) 588-5829

Fax

(731) 588-5834

NPI assigned

Apr 27, 2012

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

Other identifiers 1

Other names 1

• Carla Hernandez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1558629501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371110640",
            "telephone_number": "931-507-1212",
            "fax_number": "931-507-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 UNIVERSITY ST",
            "city": "MARTIN",
            "state": "TN",
            "postal_code": "382371605",
            "telephone_number": "731-588-5829",
            "fax_number": "731-588-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "CARLA",
        "middle_name": "ROSANNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "65167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "65167",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "HERNANDEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan S Stone
• Stooksberry Family Dental P.C.
• Amiee Foley Stooksberry, APRN
• Patrick Michael Stooksberry, D.D.S.
• Haley Sullivan, ATC, LAT
• Amanda Supeck, OTR/ L
• Surgical Associates of Martin PC
• Surgical Specialists P C
• Cynthia Raines Swaim, M.D.
• Michael Gregg Swaim, DPH

• Licensed Practical Nurse in Martin, TN
• Providers in Martin, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2012; 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.