MEDICARE: NICKLAS SUMMERS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305216289	VA

General Provider Information

NPI Number	:	1417700022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICKLAS SUMMERS DPT

Provider Business Mailing Address
First Line	:	18169 MORGARTS BEACH RD
Second Line	:
City	:	SMITHFIELD
State	:	VA
Zip	:	23430-2623
Country	:	US
Telephone Number	:	618-218-9535
Fax Number	:

Provider Business Practice Location Address
First Line	:	5818 HARBOUR VIEW BLVD STE 150
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23435-3327
Country	:	US
Telephone Number	:	747-215-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	04/11/2024

Similar Medicare Providers

1700888963 — DAVID E LANNIK MD
Practice Location Address:

5818 D HARBOUR VIEW BLVD , SUITE 150
SUFFOLK, VA
23435-3327

Practice Phone: 757-215-1400
Practice Fax: 757-215-1403

1194136309 — REBECCA JO HODGES LPC
Practice Location Address:

3327 NANSEMOND RIVER DR
SUFFOLK, VA
23435-1057

Practice Phone: 757-809-0909
Practice Fax:

1639748999 — MONICA LOGWOOD
Practice Location Address:

5818 HARBOUR VIEW BLVD STE 150
SUFFOLK, VA
23435-3327

Practice Phone: 757-215-1400
Practice Fax:

1144549023 — MS. DONNA A. WAKELEY MS CCC SLP LIC.
Practice Location Address:

319 SUFFOLK ST # 56
BUFFALO, NY
14215-3327

Practice Phone: 716-816-4330
Practice Fax: 716-838-7530

1700506425 — MRS. ANJULI MARIE CHASE RN
Practice Location Address:

319 SUFFOLK ST
BUFFALO, NY
14215-3327

Practice Phone: 716-816-4327
Practice Fax: 716-838-7528

1114692720 — BROOKE E STRICKLAND
Practice Location Address:

5833 HARBOUR VIEW BLVD
SUFFOLK, VA
23435-3760

Practice Phone: 757-455-5000
Practice Fax:

Directions to “ NICKLAS SUMMERS DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.