Jessica Sullenberger

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2056595 Issued in TX

Practice address

1640 West Redstone Center Dr
Suite 200
Park City, UT 84098

Phone

(435) 776-7235

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1659588176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63",
            "address_2": "418 GALLIMORE RD",
            "city": "PORT WILLIAM",
            "state": "OH",
            "postal_code": "451640063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 WEST REDSTONE CENTER DR",
            "address_2": "SUITE 200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-776-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLENBERGER",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 20373",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA 05746",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2056595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne L Stokes, MD
• Karen R Stolman, MD
• Christopher Stoner, D.O.
• Tarah Rachele Stowell, L.C.S.W.
• Successware LLC
• Summit County Clubhouse
• Summit County Early Intervention
• Summit Sports Performance and Rehab Center, PLLC
• Jeffrey Rex Sumsion, DMD, MS
• Sundance Counseling LLC

• Physical Therapy Assistant in Park City, UT
• Providers in Park City, UT by specialty
• Physical Therapy Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.