MR. SAMUEL ALAN SULLIVAN
NPI 1295538106
Student in an Organized Health Care Education/Training Program in Fort Walton Beach, FL
About Mr. Samuel Alan Sullivan NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. SAMUEL ALAN SULLIVAN (NPI 1295538106) is an individual student in an organized health care education/training program in Fort Walton Beach, Florida and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Samuel Alan Sullivan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WALTON BEACH, FL 32547
FORT WALTON BEACH, FL 32547
FT WALTON BEACH, FL 32547
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel Sullivan's NPI number?
The NPI number for Samuel Sullivan is 1295538106. It was assigned to this individual provider in the NPPES registry on March 28, 2025.
Where is Samuel Sullivan located?
Samuel Sullivan practices at 1000 Mar Walt Dr, Fort Walton Beach, FL 32547. The listed phone number is (217) 274-0529.
What is Samuel Sullivan's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Samuel Sullivan enrolled in Medicare?
Yes. Samuel Sullivan is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Samuel Sullivan was last updated on March 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.
