Kelsey Sue Summerville, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9493 Issued in MN

Practice address

508 9TH St N
Wahpeton, ND 58075-4098

Phone

(701) 642-3050

NPI assigned

Aug 29, 2016

Last updated

Aug 13, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Orthopedic & Sports Physical Therapy, Inc

  • Multi-Specialty Clinic/Center
  • Breckenridge, MN
  • NPI 1811923535
  Medicare reassignment NPD
• Orthopedic & Sports Physical Therapy Inc.

  • Physical Therapist
  • Hankinson, ND
  • NPI 1225215338
  Medicare reassignment

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1659827848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 9TH ST N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754098",
            "telephone_number": "701-642-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 9TH ST N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754098",
            "telephone_number": "701-642-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERVILLE",
        "first_name": "KELSEY",
        "middle_name": "SUE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Steckler
• Duane D Strand, MD
• Alyssa Stuehrenberg
• Kortney Vickie Sturgess
• Christopher Sue, MD
• Susan L. Swanson, DDS
• The Leach Home
• Three Rivers Dental
• Dylan M Torgerson, MD
• Kara Ann Trom, BSN, RN, CDE

• Speech-Language Pathologist in Wahpeton, ND
• Providers in Wahpeton, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.