Angela Sullivan, M.S., OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC006729L Issued in PA

Practice address

401 Hazle Township Blvd # 403
Hazle Township, PA 18202-9661

Phone

(570) 454-8888

NPI assigned

Aug 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Advanced Inpatient Medicine Transitional Care PC

  • Internal Medicine Physician
  • Wilkes Barre, PA
  • NPI 1609247030
  NPD (past)

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

{
    "created_epoch": "1250380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1023240660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 HONEY POT ST REAR",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186341541",
            "telephone_number": "570-735-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAZLE TOWNSHIP BLVD # 403",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182029661",
            "telephone_number": "570-454-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "463 N Hunter Hwy",
            "address_2": "Therapy Dept.",
            "address_purpose": "LOCATION",
            "city": "Drums",
            "state": "PA",
            "postal_code": "182222129",
            "country_code": "US",
            "telephone_number": "570-788-4175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANGELA",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-16",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC006729L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spark Oral Surgery PA, PLLC
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• Peter John Spohn, MD
• St. Luke'S Physician Group, Inc
• Laura Amann Storm, PA-C
• Christopher Joseph Surina, PA-C
• Molly Ann Sweeney, MS, RDN, LDN, CDE
• Lisa Marie Tacoronte, LPN
• The Carbon Schuylkill Community Hospital, Inc.
• Jacque Anne Thomas, CRNP

• Occupational Therapist in Hazle Township, PA
• Providers in Hazle Township, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.