Individual provider Active NPI

Megan Sullivan, PT

  • Physical Therapist
  • South Miami, FL
National Provider Identifier
1265583793
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36441 Issued in FL
Practice address
7800 SW 57TH Ave
South Miami, FL 33143-5528
Phone
(305) 779-2427
Fax
(305) 779-2437
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT36441 FL Primary
Physical Therapist 225100000X PT00009862 WA

Addresses

Primary practice location

7800 SW 57TH Ave
South Miami, FL 33143-5528

Mailing address

7800 SW 57TH Ave
South Miami, FL 33143-5528
Phone (305) 779-2427

Other practice location 1

19820 Scriber Lake Rd
Lynnwood, WA 98036-6121
Phone (425) 673-5220

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT36441FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Rehabilitation, Inc PastSince Apr 1, 2007 Accepting new patients
Physical Therapy and Sports Medicine Binh M. Tran PT, Inc. Physical Therapist Past Accepting new patients
Action Reaction Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Pain Free Move Well PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1265583793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 SW 57TH AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435528",
            "telephone_number": "305-779-2427",
            "fax_number": "305-779-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SW 57TH AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435528",
            "telephone_number": "305-779-2427",
            "fax_number": "305-779-2437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19820 Scriber Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366121",
            "country_code": "US",
            "telephone_number": "425-673-5220",
            "fax_number": "425-673-1597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MEGAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36441",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00009862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.