Stephanie M Sullivan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT021352.MIL Issued in OH

Practice address

800 Grayson LN
Beavercreek, OH 45430-1783

Phone

(866) 360-9355

NPI assigned

May 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aegis Group Practice LLC

  • Physical Therapist
  • Mansfield, OH
  • NPI 1093389751

  Multi-Specialty

  Medicare reassignment NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Cincinnati, OH
  • NPI 1154995603

  Multi-Specialty

  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1861650970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E 86TH ST STE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401840",
            "telephone_number": "866-360-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAYSON LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301783",
            "telephone_number": "866-360-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03805",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021352.MIL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilie Marie Sturgill, MS ED, LPC
• Sho-CHI Su, O.D.
• Jack Joseph Sudekum
• Dennis Michael Sullivan, M.D.
• Kelly Glen Sullivan
• Stephanie Lynn Summerlin
• Theresa M Sutak, MSN, APRN, FNP-C
• Holly A Sutton
• Antonela Svetic, MD
• Charles Swafford II, APRN-CNP

• Physical Therapist in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.