Jeremiah Sullivan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30563 Issued in FL

Practice address

1857 Gulf to Bay Blvd
Clearwater, FL 33765-3415

Phone

(727) 408-5222

Fax

(727) 408-5252

NPI assigned

Aug 20, 2015

Last updated

Aug 20, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24544/brand/1/csg/1/fhir/r4

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.

• Advanced Medical of Florida LLC

  • Physical Therapist
  • Clearwater, FL
  • NPI 1053728782
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1710353081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1857 GULF TO BAY BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653415",
            "telephone_number": "727-408-5222",
            "fax_number": "727-408-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1857 GULF TO BAY BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653415",
            "telephone_number": "727-408-5222",
            "fax_number": "727-408-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JEREMIAH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Suchar, DO
• Pranvera Suci, TCM SUPERVISOR
• Elizabeth A Suggs, LCSW
• Carrie Sullivan
• Garry Sullivan
• Kathleen Sullivan, RN
• Sumilang Health Care LLC (Primecare Home Health)
• Summer Set Diagnostics LLC
• Summerville 9 LLC (Brookdale Beckett Lake)
• Summerville at Clearwater LLC (Brookdale Clearwater)

• Physical Therapist in Clearwater, FL
• Providers in Clearwater, 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 20, 2015; 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.