Active NPI
Megan Virginia Sullivan, PTA
- Physical Therapy Assistant
- Sebring, FL
National Provider Identifier
1396404471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 31674
- Practice address
- 6120 US Highway 27 N
Sebring, FL 33870-1221 - Phone
- (863) 471-1223
- NPI assigned
- Dec 15, 2021
- 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 Therapy Assistant | 225200000X | 31674 | FL | Primary |
Addresses
Primary practice location
6120 US Highway 27 N
Sebring, FL 33870-1221
Mailing address
1031 S Scenic Hwy
Lake Wales, FL 33853-4823
Phone (863) 632-9550
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 |
|---|---|---|---|
| 31674 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1396404471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1031 S SCENIC HWY",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338534823",
"telephone_number": "863-632-9550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6120 US HIGHWAY 27 N",
"city": "SEBRING",
"state": "FL",
"postal_code": "338701221",
"telephone_number": "863-471-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MEGAN",
"middle_name": "VIRGINIA",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-15",
"last_updated": "2021-12-15",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "31674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebring, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.