Individual provider Active NPI

Summer A Snoek, PT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1750665808
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26833 Issued in FL
Practice address
105 Mariner Health Way
Ste 213
St Augustine, FL 32086-3251
Phone
(904) 217-4259
Fax
(904) 217-4251
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT26833 FL Primary

Addresses

Primary practice location

105 Mariner Health Way
Ste 213
St Augustine, FL 32086-3251

Mailing address

105 Mariner Health Way
Ste 213
St Augustine, FL 32086-3251
Phone (904) 217-4259

Other identifiers 2

IdentifierTypeStateIssuer
P01025527OtherFLRR MEDICARE
Y08Y9OtherFLBCBS

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1750665808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY",
            "address_2": "STE 213",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY",
            "address_2": "STE 213",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOEK",
        "first_name": "SUMMER",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01025527",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y08Y9",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.