Individual provider Active NPI

Cecelia Elizabeth Summers, PT, DPT

  • Physical Therapist
  • Athens, OH
National Provider Identifier
1801521356
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP014782T Issued in NH
Practice address
7255 Ervin Rd Apt a
Athens, OH 45701-3523
Phone
(740) 593-1000
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305215153 VA
Physical Therapist 225100000X PT019956 OH
Physical Therapist 225100000X
Physical Therapist 225100000X CP014782T NH Primary

Addresses

Primary practice location

7255 Ervin Rd Apt a
Athens, OH 45701-3523

Mailing address

7255 Ervin Rd Apt a
Athens, OH 45701-3523
Phone (740) 593-1000

Other practice location 1

209 N Madison Rd
Orange, VA 22960
Phone (540) 672-2708

Other practice location 2

24 Old Etna Rd
Lebanon, NH 03766-1937
Phone (603) 448-2234

Other names 1

  • Cecelia Elizabeth Wallace Former name

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

State licenses

LicenseStateTypeSpecialty
CP014782TNHMDPhysical Therapist
PT019956OHMDPhysical Therapist
2305215153VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Sept, LLC Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients
Ivyrehab Sept, LLC Physical Therapist PastSince Jul 1, 2022 Accepting new patients

Locations

209 N Madison Rd
Orange, VA 22960
Phone (540) 672-2708

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1801521356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 ERVIN RD APT A",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013523",
            "telephone_number": "740-593-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 ERVIN RD APT A",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013523",
            "telephone_number": "740-593-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 N Madison Rd",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "VA",
            "postal_code": "22960",
            "country_code": "US",
            "telephone_number": "540-672-2708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Old Etna Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037661937",
            "country_code": "US",
            "telephone_number": "603-448-2234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "CECELIA",
        "middle_name": "ELIZABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215153",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT019956",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "CP014782T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECELIA",
            "last_name": "WALLACE",
            "middle_name": "ELIZABETH",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.