Michelle Sullivan, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19629 Issued in NC

Practice address

292 Commerce Ave
Southern Pines, NC 28387-7059

Phone

(910) 757-0408

Fax

(910) 757-0413

NPI assigned

Dec 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michelle George Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME, NC2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

University of Colorado School of Medicine, Denver, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCPC-12 LLCGroup PAC ID 7416198890, 32 clinicians

Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063
  Medicare reassignment Care Compare group NPD
• MCPC-12, LLC

  • Gynecology Physician
  • Pinehurst, NC
  • NPI 1306283080
  Medicare reassignment Care Compare group
• Carolina Strong Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Southport, NC
  • NPI 1851783815

  Physical Therapist

  NPD

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770163200000",
    "number": "1376727909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "910-757-0408",
            "fax_number": "910-757-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 COMMERCE AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877059",
            "telephone_number": "910-757-0408",
            "fax_number": "910-757-0413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4002 Executive Park Blvd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Southport",
            "state": "NC",
            "postal_code": "284619069",
            "country_code": "US",
            "telephone_number": "910-477-6236",
            "fax_number": "910-477-6357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHELLE",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT2584",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19629",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "218905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Portland",
            "affiliation": "Y",
            "endpointDescription": "EMR",
            "affiliationName": "Jade Trade Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1023 Washington Ave",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041032793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GEORGE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• William L. Stewart, M.D.
• Susan Goldenberg Stovall, PT
• Leigh Ann Strain, BCBA
• Katie Cole Strathmann, BCBA, LCSW
• Mallory Sullivan
• Michael John Sundborg, M.D.
• Natalie Nicole Sutton, LCSW, LCAS
• Christine Theresa Swope
• Assma Syed Ahamed
• Rebecca Sykes, D.D.S

• Physical Therapist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.