Marlysa Sullivan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT007465 Issued in GA

Practice address

3901 Loch Raven Blvd
Baltimore, MD 21218-2109

Phone

(404) 791-5230

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back 2 Motion

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1700107984
  NPD (past)
• Foundation Therapy Center - North Atlanta, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1962460451
  NPD (past)
• Foundation Therapy Center-Alpharetta, LLC

  • Physical Therapist
  • Roswell, GA
  • NPI 1447283635
  NPD (past)
• Independent Physical Therapy of Georgia, LLC

  dba BenchMark Physical Therapy

  • Physical Therapy Clinic/Center
  • Woodstock, GA
  • NPI 1912950569
  NPD (past)
• Reid Clinic Sports Physical Therapy and Spine LLC

  • Physical Therapy Clinic/Center
  • Roswell, GA
  • NPI 1609106418
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1578632816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182109",
            "telephone_number": "404-791-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARLYSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "PT007465",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Page Sullivan, CRNP-PMH
• Kammie Lynnette Sullivan, OTR/L
• Kathleen D Sullivan, LCPC
• Kelsey Sullivan
• Marlon Sullivan
• Maryam A Sullivan
• Meghan Elizabeth Sullivan, MS, ATC, CES, PES
• Michael David Sullivan, MD
• Miles Schaeffer Sullivan, MD
• Sarah A Sullivan, FNP

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.