Active NPI
Matthew Sean Sullivan, LMT
- Massage Therapist
- Sarasota, FL
National Provider Identifier
1376806596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA68340
- Practice address
- 4370 S Tamiami TRL
Sarasota, FL 34231-3412 - Phone
- (941) 350-1669
- NPI assigned
- Jun 21, 2012
- Sex
- Male
- 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 | MA68340 | FL | Primary |
Addresses
Primary practice location
4370 S Tamiami TRL
Sarasota, FL 34231-3412
Mailing address
120 Bayshore Rd
Nokomis, FL 34275-1904
Phone (941) 350-1669
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 |
|---|---|---|---|
| MA68340 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1376806596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 BAYSHORE RD",
"city": "NOKOMIS",
"state": "FL",
"postal_code": "342751904",
"telephone_number": "941-350-1669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4370 S TAMIAMI TRL",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342313412",
"telephone_number": "941-350-1669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MATTHEW",
"middle_name": "SEAN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-21",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA68340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.