Summit Physical Therapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SUMMIT PHYSICAL THERAPY, PLLC

Practice address

2219 County Road 220 Ste 304
Middleburg, FL 32068-7778

Phone

(904) 644-7722

Fax

(904) 637-1532

NPI assigned

Mar 18, 2025

Organization subpart

No

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

Authorized official

Name

Tara Reeves VollertsenNPI 1144363680

Title

Owner

Phone

(904) 644-7722

Specialties & licenses 1

Addresses

Tax ID family

Summit Physical Therapy PLL5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Orange Park, FL
  • NPI 1225817695
  NPD tax ID
• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Orange Park, FL
  • NPI 1295591022
  NPD tax ID
• Summit Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Green Cove Springs, FL
  • NPI 1508548371
  NPD tax ID
• Summit Physical Therapy, PLLC

  • Physical Therapist
  • Middleburg, FL
  • NPI 1992348569
  NPD tax ID

Locations

Practitioners 2

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

• Tara Reeves Vollertsen, DPT

  • Physical Therapist
  • Middleburg, FL
  • NPI 1144363680
  NPD (past) Authorized official
• Roshini Anita Mazy, OT

  • Occupational Therapist
  • Jacksonville, FL
  • NPI 1215421276
  NPD

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1992505945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 COUNTY ROAD 220 STE 304",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687778",
            "telephone_number": "904-644-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 COUNTY ROAD 220 STE 304",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320687778",
            "telephone_number": "904-644-7722",
            "fax_number": "904-637-1532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Kingsley Ave Ste 11",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735129",
            "country_code": "US",
            "telephone_number": "904-531-5500",
            "fax_number": "904-637-1532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11481 Old Saint Augustine Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322581476",
            "country_code": "US",
            "telephone_number": "904-903-7719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1305 N Orange Ave Ste 118",
            "address_purpose": "LOCATION",
            "city": "Green Cove Springs",
            "state": "FL",
            "postal_code": "320432553",
            "country_code": "US",
            "telephone_number": "904-531-5500",
            "fax_number": "904-637-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "VOLLERTSEN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "REEVES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-644-7722"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Steed, FNP
• Kelsea Dean Stewart
• Lisa Robyn Stiller, LCSW
• Michelle B Sullivan, ARNP
• Summit Physical Therapy, PLLC
• Sunshine State Midwifery Services
• Superior Services for Elderly Disabled LLC
• William David Swartout
• Lynn Ann Swartz, DPT
• Catrina M Taggart, MSW

• Physical Therapy Clinic/Center in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.