Stephen L. Summers, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

000879 Issued in WV

Practice address

4301 Maccorkle Ave S.E.
Charleston, WV 25304

Phone

(304) 720-9185

Fax

(304) 720-9186

NPI assigned

Jul 19, 2006

Last updated

Sep 2, 2020By the provider in NPPES

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy, PLLCGroup PAC ID 6103816806, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Physical Therapy, PLLC

  • Physical Therapist
  • Charleston, WV
  • NPI 1538236104
  Medicare reassignment Care Compare group NPD
• Elk Valley Physical Therapy Inc

  • Physical Therapist
  • Elkview, WV
  • NPI 1073824918
  Medicare reassignment NPD

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1659391373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS ST STE 400",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011854",
            "telephone_number": "304-343-4583",
            "fax_number": "304-343-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MACCORKLE AVE S.E.",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-720-9185",
            "fax_number": "304-720-9186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 MacCorkle Ave SW",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253031263",
            "country_code": "US",
            "telephone_number": "304-744-2300",
            "fax_number": "304-744-8195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 Morris St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011854",
            "country_code": "US",
            "telephone_number": "304-344-3551",
            "fax_number": "304-342-6927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "STEPHEN",
        "middle_name": "L.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "000879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650019724",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157001000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001720895",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000217253",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Carol Sullivan, FNP-BC
• Rebecca Oyler Sullivan, CRNA
• Sara Sullivan
• Cherie Summers
• Jeffrey Lee Summers, DC
• Taylor Mackenzie Summers, PA-C
• Summit BHC West Virginia LLC (Highland Hospital)
• Summit BHC West Virginia LLC (Highland Health Center)
• Summit BHC West Virginia LLC (Highland Residential)
• Summit BHC West Virginia, LLC (Highland Physicians Group)

• Physical Therapist in Charleston, WV
• Providers in Charleston, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.