Individual provider Active NPI

Christie Sullivan Heath, P.T.

  • Specialist
  • Zachary, LA
National Provider Identifier
1558317511
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3583 Issued in LA
Practice address
1219 Church St
Zachary, LA 70791-2347
Phone
(225) 658-7751
Fax
(225) 658-7753
NPI assigned
May 25, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3583 LA Primary

Addresses

Primary practice location

1219 Church St
Zachary, LA 70791-2347

Mailing address

1219 Church St
Zachary, LA 70791-2347
Phone (225) 658-7751

Other names 1

  • Mrs. Christie Lauren Sullivan Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181115001453 OK Practitioner - Physical Therapist in Private Practice 5092726224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Louisiana State University School of Medicine in Shreveport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Rock Health and Wellness LLCGroup PAC ID 7618221375, 7 clinicians

Practice addresses (Care Compare)

103 W Main St
Marlow, OK 73055-2437
Phone (580) 721-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3583LAMDSpecialist
4496OKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Rock Health and Wellness LLC CurrentSince Oct 22, 2018 Accepting new patients
Kleinpeter Physical Therapy, LLC Specialist PastSince Sep 4, 2012 Accepting new patients

Locations

103 W Main St
Marlow, OK 73055
Phone (580) 658-2319

Organizations & group practices 2

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558317511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912347",
            "telephone_number": "225-658-7751",
            "fax_number": "225-658-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912347",
            "telephone_number": "225-658-7751",
            "fax_number": "225-658-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATH",
        "first_name": "CHRISTIE",
        "middle_name": "SULLIVAN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "3583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIE",
            "last_name": "SULLIVAN",
            "middle_name": "LAUREN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.