Shakieria Renee Sullivan

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

Practice address

4680 Lake Underhill Rd
Orlando, FL 32807-1182

Phone

(407) 852-3300

NPI assigned

Sep 28, 2020

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

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.

• United Cerebral Palsy of Central Florida, Inc.

  • Voluntary or Charitable Agency
  • Orlando, FL
  • NPI 1760159800
  NPD (past)
• United Cerebral Palsy of Central Florida, Inc.

  • Voluntary or Charitable Agency
  • Orlando, FL
  • NPI 1831122019
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1255948725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4780 DATA CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328178331",
            "telephone_number": "407-852-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328071182",
            "telephone_number": "407-852-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHAKIERIA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorry Lyn Sullivan
• Mary Sullivan, PTA
• Reilly David Sullivan, PTA
• Robert Sullivan, M.D.
• Sandra K Sullivan, ARNP
• Sharon Sullivan, LMHC
• Esmeralda Sully
• Syeda N Sultana, M.D.
• Sevara Sultanova, MD
• Fawzia Sultany, MD

• Occupational Therapy Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.