Joann D Sullivan, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23388 Issued in FL

Practice address

626 N Tyndall Pkwy
Panama City, FL 32404-6132

Phone

(850) 871-6363

NPI assigned

Aug 9, 2013

Last updated

Aug 9, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Joann D Kracl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1568895803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 OAK FOREST DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324045783",
            "telephone_number": "850-625-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N TYNDALL PKWY",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324046132",
            "telephone_number": "850-871-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOANN",
        "middle_name": "D",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "23388",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "009282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANN",
            "last_name": "KRACL",
            "middle_name": "D",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terra Sturgill
• Arian Alejandro Suarez Valderas
• Amy D Sullivan, PTA
• Cherie Sullivan, SLP
• Haley Brooke Sullivan, PA-C
• Scott G Sullivan, PA
• Melisa Diane Summers, APRN
• Marsha Lynn Sumner, APRN
• Sun Dermatology LLC
• Suncoast Open MRI LLC (Suncoast Diagnostic Imaging)

• Physical Therapist in Panama City, FL
• Providers in Panama City, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.