Active NPI
Susan M Sullivan, L.M.T.
- Massage Therapist
- Williamsville, NY
National Provider Identifier
1124382700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 010290-1
- Practice address
- 8655 Main St
Williamsville, NY 14221-7501 - Phone
- (716) 807-5228
- NPI assigned
- Jun 28, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 010290-1 | NY | Primary |
Addresses
Primary practice location
8655 Main St
Williamsville, NY 14221-7501
Mailing address
8655 Main St
Williamsville, NY 14221-7501
Phone (716) 807-5228
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420761600000",
"number": "1124382700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8655 MAIN ST",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142217501",
"telephone_number": "716-807-5228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8655 MAIN ST",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142217501",
"telephone_number": "716-807-5228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-28",
"last_updated": "2015-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "010290-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.