Jacqueline R Summers, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002477 Issued in GA

Practice address

1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319-1415

Phone

(404) 943-1070

Fax

(404) 943-0890

NPI assigned

May 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1861659690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 STONINGTON TRACE PKWY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300875248",
            "telephone_number": "770-879-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAKE HEARN DR NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303191415",
            "telephone_number": "404-943-1070",
            "fax_number": "404-943-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OY002477",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "028577889",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany R Summerlin, RD, LD
• Lauren Summerour, NP
• Michie Summers-Perez
• Aerica Sadler Summers, M.D., M.P.H
• Andrew Summers, PA-C
• Kelly Elizabeth Summers, PA
• Kendra Summers
• Ryan Summers, MD
• Summerset Assisted Living Inc.
• Kelli Elizabeth Summey

• Occupational Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.