Active NPI
Julie Ann Sullivan, PT, DPT
- Physical Therapist
- San Luis Obispo, CA
National Provider Identifier
1801467212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT300391
- Practice address
- 805 Aerovista PL Ste 104
San Luis Obispo, CA 93401-7921 - Phone
- (805) 543-7771
- Fax
- (805) 543-7761
- NPI assigned
- Jul 7, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT300391 | CA | Primary |
Addresses
Primary practice location
805 Aerovista PL Ste 104
San Luis Obispo, CA 93401-7921
Mailing address
408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT300391 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Luis Physical Therapy & Orthopedic Rehabilitation Inc | Physical Therapist | Past | 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.
-
- Physical Therapy Clinic/Center
- Atascadero, CA
- NPI 1225046824
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1801467212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 HIGUERA ST STE 200",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934016135",
"telephone_number": "805-788-0805",
"fax_number": "805-788-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 AEROVISTA PL STE 104",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934017921",
"telephone_number": "805-543-7771",
"fax_number": "805-543-7761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JULIE",
"middle_name": "ANN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-07",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT300391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.