Individual provider Active NPI

Brooke Francis Sullivan

  • Physical Therapist
  • Knightdale, NC
National Provider Identifier
1235878984
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21470 Issued in NC
Practice address
6905 Knightdale Blvd Ste 102
Knightdale, NC 27545-6506
Phone
(919) 373-8086
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P21470 NC Primary

Addresses

Primary practice location

6905 Knightdale Blvd Ste 102
Knightdale, NC 27545-6506

Mailing address

3557 Ramsay St Apt 2a
High Point, NC 27265-9024
Phone (713) 569-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230306001084 NC Practitioner - Physical Therapist in Private Practice 1153794516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activcare Physical Therapy, LLCGroup PAC ID 8628027471, 126 clinicians

Practice addresses (Care Compare)

3708 Forestview Rd
Suite 101
Raleigh, NC 27612-8042
Phone (919) 786-7434

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
85.21
Promoting interoperability
99
Improvement activities
40
Cost
77.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Oct 18, 2022 Accepting new patients

Locations

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

6905 Knightdale Blvd
Ste 102
Knightdale, NC 27545
Phone (919) 350-5755

3708 Forestview Rd
Ste 101
Raleigh, NC 27612
Phone (919) 786-7434

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

Interoperability endpoints

  • Direct secure messaging: brooke.sullivan.p12@direct.athleticoltd.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1235878984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 RAMSAY ST APT 2A",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659024",
            "telephone_number": "713-569-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 KNIGHTDALE BLVD STE 102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456506",
            "telephone_number": "919-373-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BROOKE",
        "middle_name": "FRANCIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.