Individual provider Active NPI

Summer Lee Haviland, DPT

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1578877627
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15153 Issued in TN
Practice address
7003 Shallowford Rd Ste 102
Chattanooga, TN 37421-6722
Phone
(423) 888-6238
Fax
(423) 220-8238
NPI assigned
Jul 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Ergonomics Physical Therapist 2251E1200X
Geriatric Physical Therapist 2251G0304X
Sports Physical Therapist 2251S0007X
Orthopedic Physical Therapist 2251X0800X
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 15153 TN Primary

Addresses

Primary practice location

7003 Shallowford Rd Ste 102
Chattanooga, TN 37421-6722

Mailing address

7003 Shallowford Rd Ste 102
Chattanooga, TN 37421-6722
Phone (423) 888-6238

Other names 1

  • Dr. Summer Lee Wilkerson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209002985 TN Practitioner - Physical Therapist in Private Practice 6204098197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Un of California, Irvine, College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2288 Gunbarrel Rd
Suite 154/340
Chattanooga, TN 37421-2670

7003 Shallowford Rd
Suite 102
Chattanooga, TN 37421-6722
Phone (423) 888-6238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Physical Therapy Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

7003 Shallowford Rd
Ste 102
Chattanooga, TN 37421
Phone (423) 805-7587

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1280534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1578877627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7003 SHALLOWFORD RD STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216722",
            "telephone_number": "423-888-6238",
            "fax_number": "423-220-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7003 SHALLOWFORD RD STE 102",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216722",
            "telephone_number": "423-888-6238",
            "fax_number": "423-220-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILAND",
        "first_name": "SUMMER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-31",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "15153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUMMER",
            "last_name": "WILKERSON",
            "middle_name": "LEE",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.