NPIMap

Organization Active NPI

Sullivan Rehab Inc

  • Physical Therapist
  • Brandon, FL
National Provider Identifier
1881798353
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SULLIVAN REHAB INC
Practice address
116 E Bloomingdale Ave
Brandon, FL 33511-8101
Phone
(813) 655-3342
Fax
(813) 653-0894
NPI assigned
Sep 12, 2006
Last updated
Aug 31, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Authorized official

Name
Amy Marsh
Title
Director
Phone
(813) 655-3342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

116 E Bloomingdale Ave
Brandon, FL 33511-8101

Mailing address

116 E Bloomingdale Ave
Brandon, FL 33511-8101
Phone (813) 655-3342

Other identifiers 2

IdentifierTypeStateIssuer
Y908VOtherFLBLUE CROSS BLUE SHIELD PR
6405105OtherFLUNITED HEALTH CARE

National Provider Directory

National Provider Directory

Locations

116 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 655-3342

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188518400000",
    "number": "1881798353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118101",
            "telephone_number": "813-655-3342",
            "fax_number": "813-653-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118101",
            "telephone_number": "813-655-3342",
            "fax_number": "813-653-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-08-31",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-655-3342"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PR",
            "identifier": "Y908V",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "6405105",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.