Marisol Sullivan

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

50 N Medical Dr
Salt Lake City, UT 84132-0001

Phone

(801) 581-2843

NPI assigned

Dec 1, 2021

Sex

Female

Sole proprietor

No

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.

• Reborn Pelvic Health & Wellness

  • Physical Therapy Clinic/Center
  • Murray, UT
  • NPI 1740884907

  Physical Therapist, UT

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Rehabilitation Clinic/Center
  • Salt Lake City, UT
  • NPI 1033822085

  Physical Therapist, UT

  Medicare reassignment NPD
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870

  UT

  Medicare reassignment NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  NPD
• University of Utah Healthcare

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Salt Lake City, UT
  • NPI 1235546573
  NPD

Specialty

Physical Therapist in Private Practice

Education

University of Utah School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services Inc 3,948 clinicians

Reborn Pelvic Health and Wellness 17 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msullivan546586@direct.med.utah.edu

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2022.

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1558029199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARISOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MSULLIVAN546586@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kellen A. Sullivan, MD
• Kelly Lee Sullivan
• Kristen Gallup Sullivan, OTR/L
• Lauren Sullivan
• Lindsay Sullivan
• Megan Sonja Sullivan, FNP-C
• Sydney Sullivan
• Tricia Sullivant, CSW
• Cindy Emilia Alexandra Sumarauw, DDS
• Daniel D. Summerfield, MD

• All providers in Salt Lake City, UT
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2022; 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.