Katie E. Sullivan, PT, DPT, NCS

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

PTL.0016395 Issued in CO

Practice address

3141 Centennial Blvd
Colorado Springs, CO 80907-4094

Phone

(192) 274-5347

NPI assigned

Nov 3, 2016

Last updated

May 24, 2021By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Richmond, VA
  • NPI 1386165264
  NPD (past)
• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Norfolk, VA
  • NPI 1538680400
  NPD (past)
• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Richmond, VA
  • NPI 1588185458
  NPD (past)
• Tidewater Physical Therapy LLC

  dba Pivot Physical Therapy of Virginia

  • Physical Therapist
  • Suffolk, VA
  • NPI 1831610708
  NPD (past)
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1093172181
  NPD (past)
• Tidewater Physical Therapy, LLC

  dba Pantops Physical Therapy

  • Physical Therapist
  • Palmyra, VA
  • NPI 1881133791
  NPD (past)

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1740732080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074094",
            "telephone_number": "192-274-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074094",
            "telephone_number": "192-274-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATIE",
        "middle_name": "E.",
        "credential": "PT, DPT, NCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210768",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CO",
            "license": "PTL.0016395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "C05954",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah A Sullivan, NP
• Eric Sullivan, PHARM.D
• Jessica Sullivan, CCC-SLP
• Jessie Mae Sullivan, RD
• Kathryn Harriet Sullivan, RPH
• Kelly Colleen Sullivan, MA, PLMHP
• Kevin Sullivan
• Maribel Sullivan
• Shannon Sullivan
• Jaime Sumaya

• Neurology Physical Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Neurology Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.