Sumner Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SUMNER PHYSICAL THERAPY PC

Practice address

9425 Principal Ave
Atascadero, CA 93422-5589

Phone

(805) 591-0966

Fax

(805) 460-6191

NPI assigned

Jan 11, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Ethan Sumner App, PTNPI 1609283944

Title

Ceo/PT

Phone

(805) 591-0966

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ethan Sumner App, MPT

  • Physical Therapist
  • Atascadero, CA
  • NPI 1609283944
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1841061561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 PRINCIPAL AVE",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225589",
            "telephone_number": "805-591-0966",
            "fax_number": "805-460-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 PRINCIPAL AVE",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225589",
            "telephone_number": "805-591-0966",
            "fax_number": "805-460-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMNER PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "APP",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "SUMNER",
        "authorized_official_title_or_position": "CEO/PT",
        "authorized_official_telephone_number": "805-591-0966",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Stowasser, M.S., LMFT
• Luke J Stratigakes, DPT
• Ronen Stromberg
• Silvia Suarez Riano
• Mary Sullivan
• Chandler Sutton
• Chelsea Lynn Swanson
• Alyssa Switzer
• Syndi Ecker Enterprises, Inc
• Gerald Taberdo

• Physical Therapy Clinic/Center in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.