Summer Waters, LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC01181 Issued in OR

Legal business name

SUMMER WATERS, LLC

Practice address

832 E Main St
Suite 3
Medford, OR 97504-7153

Phone

(541) 326-8952

NPI assigned

Apr 28, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Summer Colella, LAC, NTP, CGP

Title

Member Manager

Phone

(541) 326-8952

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1679928543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "BUTTE FALLS",
            "state": "OR",
            "postal_code": "975220071",
            "telephone_number": "541-326-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047153",
            "telephone_number": "541-326-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMER WATERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "COLELLA",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "541-326-8952",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LAC, NTP, CGP"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Sullivan, LMT
• Heather Sullivan, FNP
• Lynn C Sullivan, FNP
• Rita De-Haan Sullivan, PH.D
• Sandra Jane Sullivan
• Brett A. Summers, R.PH
• Robin Lynn Nicole Summers
• Summit Dermatology and Aesthetics
• Summit Family Dental Care PC
• Summit View Therapy LLC

• Acupuncturist in Medford, OR
• Providers in Medford, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.