Individual provider Active NPI

Summer Sanders

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1801475793
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29452 Issued in TN
Practice address
17 Centre Plaza Dr
Jackson, TN 38305-2862
Phone
(731) 512-0104
Fax
(731) 668-7388
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN0000163452 TN
Family Nurse Practitioner 363LF0000X 29452 TN Primary

Addresses

Primary practice location

17 Centre Plaza Dr
Jackson, TN 38305-2862

Mailing address

17 Centre Plaza Dr
Jackson, TN 38305-2862
Phone (731) 512-0104

Other practice location 1

9486 Highway 412 W
Lexington, TN 38351-5713
Phone (731) 968-0984

Other practice location 2

350 E Parkview St
Dyersburg, TN 38024-3122
Phone (731) 285-7530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000001 TN Practitioner - Nurse Practitioner 3870992555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Clinics PLCGroup PAC ID 5193022994, 14 clinicians

Practice addresses (Care Compare)

17 Centre Plaza Dr
Jackson, TN 38305-2862
Phone (731) 512-0104

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
79.9
Improvement activities
40
Cost
80.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN0000163452TNMDRegistered Nurse
29452TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lauderdale Community Hospital LLC CurrentSince Jul 1, 2022 Accepting new patients
Lauderdale Community Hospital LLC CurrentSince Jul 1, 2022 Accepting new patients
Delta Clinics, PLC CurrentSince May 3, 2021 Accepting new patients

Locations

350 E Parkview St
Dyersburg, TN 38024
Phone (731) 285-1888

17 Centre Plaza Dr
Jackson, TN 38305
Phone (731) 512-0104

9486 Highway 412 W
Lexington, TN 38351
Phone (731) 512-0104

340 Asbury Ave
Ripley, TN 38063
Phone (731) 221-2200

Interoperability endpoints

  • Direct secure messaging: ssanders700999@direct.bmhcc.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

Organizations & group practices 3

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1801475793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CENTRE PLAZA DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052862",
            "telephone_number": "731-512-0104",
            "fax_number": "731-668-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CENTRE PLAZA DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052862",
            "telephone_number": "731-512-0104",
            "fax_number": "731-668-7388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9486 Highway 412 W",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "TN",
            "postal_code": "383515713",
            "country_code": "US",
            "telephone_number": "731-968-0984",
            "fax_number": "731-967-9764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 E Parkview St",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380243122",
            "country_code": "US",
            "telephone_number": "731-285-7530",
            "fax_number": "731-668-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SUMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000163452",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.