Katherine Josephine Sullivan, PT

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

14280 Issued in CA

Practice address

194 Loch Lomond Rd
Rancho Mirage, CA 92270

Phone

(626) 674-0361

NPI assigned

Aug 19, 2014

Sex

Female

Sole proprietor

No

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 CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• 360 Wellness Solutions, LLC

  • Case Manager/Care Coordinator
  • Rancho Mirage, CA
  • NPI 1447773825
  Medicare reassignment Authorized official
• 360 Wellness Solutions Physical Therapy and Rehabilitation Services

  • Clinic/Center
  • Rancho Mirage, CA
  • NPI 1144952961
  NPD Authorized official

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1285033878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 LOCH LOMOND RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922705600",
            "telephone_number": "626-674-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 LOCH LOMOND RD",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "92270",
            "telephone_number": "626-674-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHERINE",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "14280",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "14280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ami Israel Student, PSY.D.
• Marcos Antonio Suarez, M.D.
• Cari Lynn Sudmeier, NP
• Mehreen Sulaiman, DMD
• Montee A Suleiman, MD
• Pamela Sue Sullivan, GNP
• Starr Sullivan, LMFT
• Superior, Inc (Advanced Hearing Systems)
• Surender Vuthoori MD Inc
• Sienna Jean Sutton

• Neurology Physical Therapist in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Neurology Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.