Mary Beth Sullivan, SPED

Primary specialty

SpecialistTaxonomy code 174400000X

License

1238212181 Issued in NY

Practice address

1 Odell PLZ Ste 263
Yonkers, NY 10701-1402

Phone

(914) 965-1152

Fax

(914) 965-1419

NPI assigned

Sep 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Beth Shewmake Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1578047031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ODELL PLZ STE 263",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011402",
            "telephone_number": "914-965-1152",
            "fax_number": "914-965-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ODELL PLZ STE 263",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011402",
            "telephone_number": "914-965-1152",
            "fax_number": "914-965-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "SPED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1238212181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SHEWMAKE",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Summit Care Physical Therapy - Yonkers PLLC
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• Specialist in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.