Active NPI
Deandre Lamont Summlin
- Rehabilitation Practitioner
- Las Vegas, NV
National Provider Identifier
1699011247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1525 Pinto LN
Apt 39
Las Vegas, NV 89106-4104 - Phone
- (702) 981-0701
- NPI assigned
- Dec 28, 2012
- Last updated
- Apr 10, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1525 Pinto LN
Apt 39
Las Vegas, NV 89106-4104
Mailing address
1525 Pinto LN
Apt 39
Las Vegas, NV 89106-4104
Phone (702) 981-0701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365552000000",
"number": "1699011247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 PINTO LN",
"address_2": "APT 39",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064104",
"telephone_number": "702-981-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 PINTO LN",
"address_2": "APT 39",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064104",
"telephone_number": "702-981-0701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMLIN",
"first_name": "DEANDRE",
"middle_name": "LAMONT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-28",
"last_updated": "2013-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
- Summit Specialty Physicians Inc
- Summit Surgical Center LLC
- Summit Wellness of DPSW LLC
- Summit Wound Healing LLC (Summit Wound Healing)
- Shalysha Summit
- Sun City Foot Care (Summerlin Foot & Ankle)
- Sun City Hospice Inc
- Sun City Medical Center PLLC
- Sun City Medical Transport
- Sun Dental Professional Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.