Casey Elizabeth Sullivan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056010748 Issued in IL

Practice address

2545 24TH St
Rock Island, IL 61201-5305

Phone

(309) 788-0458

NPI assigned

Nov 1, 2014

Last updated

Nov 1, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414800000000",
    "number": "1760887715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 24TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015305",
            "telephone_number": "309-788-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-01",
        "last_updated": "2014-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL OCCUPATIONAL THERAPY LICENSE NUMBER",
            "identifier": "056010748",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "330341",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2014; 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.