Active NPI
Samary Sullivan
- Speech-Language Assistant
- Hialeah, FL
National Provider Identifier
1649637406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SI2364
- Practice address
- 6190 NW 186TH St
Apt 207
Hialeah, FL 33015-8072 - Phone
- (786) 612-1141
- NPI assigned
- Jan 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SI2364 | FL | Primary |
Addresses
Primary practice location
6190 NW 186TH St
Apt 207
Hialeah, FL 33015-8072
Mailing address
6190 NW 186TH St
Apt 207
Hialeah, FL 33015-8072
Phone (786) 612-1141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SI2364 | FL | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ilove Children Therapy LLC | Current | Accepting new patients |
Organizations & group practices 1
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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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453680000000",
"number": "1649637406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6190 NW 186TH ST",
"address_2": "APT 207",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330158072",
"telephone_number": "786-612-1141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6190 NW 186TH ST",
"address_2": "APT 207",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330158072",
"telephone_number": "786-612-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SAMARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-25",
"last_updated": "2016-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "FL",
"license": "SI2364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.