Patrick Sullivan, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

1312118 Issued in TX

Practice address

Wilford Hall Ambulatory Surgical Center
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-9908

Phone

(210) 292-5040

NPI assigned

Aug 3, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

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  NPD (past)
• Warfighter'S Clinic

  • Pain Medicine Physician
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  • NPI 1003357765

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1487107728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WILFORD HALL AMBULATORY SURGICAL CENTER",
            "address_2": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WILFORD HALL AMBULATORY SURGICAL CENTER",
            "address_2": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Old San Francisco Rd",
            "address_purpose": "LOCATION",
            "city": "Sunnyvale",
            "state": "CA",
            "postal_code": "940866387",
            "country_code": "US",
            "telephone_number": "408-523-3060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICK",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "1312118",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "291704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Stewart, N.P/
• Suzanne B. Stinson, M.A., CCC-SP
• Michael Stringer, DPT
• Emily L Sturgill, MD
• Jane Suh, DO
• Ryan Sumpter, MD
• Ian Thor Sutherland, DDS
• Angela Marie Synatzske, DDS
• Wongelawit Deldil Tadesse, DDS
• Paul Tagashira, PA-C

• Orthopedic Physical Therapist in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Orthopedic Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.