Active NPI
Marcia Ann Sullivan, PT
- Physical Therapist
- Jackson, NJ
National Provider Identifier
1245563956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00225700
- Practice address
- 3 Dunhill Rd
Jackson, NJ 08527-2841 - Phone
- (732) 928-5871
- NPI assigned
- Sep 14, 2009
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00225700 | NJ | Primary |
Addresses
Primary practice location
3 Dunhill Rd
Jackson, NJ 08527-2841
Mailing address
3 Dunhill Rd
Jackson, NJ 08527-2841
Phone (732) 928-5871
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 |
|---|---|---|---|
| 40QA00225700 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252886400000",
"number": "1245563956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 DUNHILL RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085272841",
"telephone_number": "732-928-5871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 DUNHILL RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085272841",
"telephone_number": "732-928-5871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MARCIA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2009-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00225700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
- Ahron Strauss, LSW
- Jacqueline Suzanne Strueby, D.C.
- Claire-Melissa Suffren
- Agnieszka Sulewski, DO
- Jennifer Sullivan, BCBA
- Summit Health Services PC NJ LLC
- Shalet Sunny
- Supportive ABA Therapy LLC (Supportive ABA)
- Supportive ABA Therapy Mi LLC
- Supportive Behavioral Services LLC (Supportive Behavior Services)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.