Jeremy James Sullivan, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01081700 Issued in NJ

Practice address

801 Kings Hwy N
Fox Rehabilitation Services
Cherry Hill, NJ 08034-1513

Phone

(877) 407-3422

Fax

(877) 407-4329

NPI assigned

Mar 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services Wi LLCGroup PAC ID 1658647581, 144 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services Wi LLC

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1518483973
  Medicare reassignment Care Compare group NPD
• Thera-Dynamics, S.C.

  • Physical Therapy Clinic/Center
  • Milwaukee, WI
  • NPI 1851366983
  Medicare reassignment

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528197985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 S BROADWAY",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081041306",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 KINGS HWY N",
            "address_2": "FOX REHABILITATION SERVICES",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341513",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JEREMY",
        "middle_name": "JAMES",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01081700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikkisha Suber, DMD
• Madanika Subhash, MD
• Subspecialty Radiology Inc
• Kelly Suessegger
• Theresa M Sullivan-Steitz, PT
• Kelly A Sullivan, OT
• Kiley Lavetta Sullivan, MS, OTR/L
• Michael F Sullivan, DMD
• Patrick O. Sullivan, D.O.
• Ibrahim Sultan, M.D.

• Physical Therapist in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.