Active NPI
Kristin Sullivan
- Physical Therapist
- Mount Airy, MD
National Provider Identifier
1063698066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19793
- Practice address
- 1 Park Ave
Suite F
Mount Airy, MD 21771-5437 - Phone
- (301) 606-8383
- NPI assigned
- Jan 21, 2008
- Last updated
- Jan 21, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 19793 | MD | Primary |
Addresses
Primary practice location
1 Park Ave
Suite F
Mount Airy, MD 21771-5437
Mailing address
1 Park Ave
Suite F
Mount Airy, MD 21771-5437
Phone (301) 607-8383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19793 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200873600000",
"number": "1063698066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PARK AVE",
"address_2": "SUITE F",
"city": "MOUNT AIRY",
"state": "MD",
"postal_code": "217715437",
"telephone_number": "301-607-8383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PARK AVE",
"address_2": "SUITE F",
"city": "MOUNT AIRY",
"state": "MD",
"postal_code": "217715437",
"telephone_number": "301-606-8383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-21",
"last_updated": "2008-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "19793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Airy, MD
- Daniel Jonathan Speece, R.N. M.S.N.
- Tracey Christin Stamates, R.D., CDE
- Michelle Lynn Starks, DPT
- Steven R McKane DDS PC (Damascus Dental of Mt Airy)
- Courtney Nikol Stuebner
- Summit Dental Smile LLC
- Daphna Szanto, PT
- Jean Apollinaire Tchayep
- Helene Thaker
- The Great Atlantic and Pacific Tea Company Inc (Super Fresh Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.