Lisa M Sullivan

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI004504 Issued in PA

Practice address

4195 Gun Club Rd
Murrysville, PA 15668-9103

Phone

(724) 316-2197

NPI assigned

Mar 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa M Inklovich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Anchor Physical Therapy LLC

  • Physical Therapist
  • Pittsburgh, PA
  • NPI 1417273921
  NPD

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1982461315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4195 GUN CLUB RD",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156689103",
            "telephone_number": "724-316-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4195 GUN CLUB RD",
            "city": "MURRYSVILLE",
            "state": "PA",
            "postal_code": "156689103",
            "telephone_number": "724-316-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI004504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "INKLOVICH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stellar Physical Therapy, LLC
• Alexa Stern, LCSW
• Debra Stoll, LPC
• Jennifer Lyn Stonecheck, PT
• Erik Stynchula, D.C.
• Supportive Solutions, Inc
• Anthony Tan, M.D.
• Michael Angelo Tardio, DPT
• Tarr Hollow Chiropractic Health Center
• The Ocd Treatment and Training Institute

• Physical Therapy Assistant in Murrysville, PA
• Providers in Murrysville, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.