Rebekah Leah Sullivan

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2064418 Issued in VT

Practice address

15600 San Pedro Ave Ste 307
San Antonio, TX 78232-3739

Phone

(210) 494-2343

NPI assigned

Oct 23, 2007

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1053500322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 SAN PEDRO AVE STE 307",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 SAN PEDRO AVE STE 307",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323739",
            "telephone_number": "210-494-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBEKAH",
        "middle_name": "LEAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VT",
            "license": "2064418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Sullivan, LPC
• Mark Sullivan, RPH
• Marshall Sullivan
• Mary Sullivan, RN BSN
• Melinda Kay Sullivan
• Scott Sullivan
• Shauna Kay Sullivan
• Tara Sullivan
• Valerie Sullivan, LCSW
• Veronica Carmelina Sullivan, OTR

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.