Matthew Sullivan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11147 Issued in SC

Practice address

535 Laurens Rd
Woodruff, SC 29388-2209

Phone

(864) 476-6600

Fax

(864) 476-3514

NPI assigned

Mar 8, 2022

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 SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment NPD
• The Weston Group of South Carolina Inc

  • Physical Therapist
  • Bluffton, SC
  • NPI 1073957064
  Medicare reassignment NPD
• Pro Physical Therapy, Inc.

  • Physical Therapist
  • Columbus, NC
  • NPI 1952359010

  SC

  Medicare reassignment NPD
• Greenville Proaxis Therapy LLC

  dba ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
  • NPI 1740052000
  NPD

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1780331991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SHUFORD RD",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287227406",
            "telephone_number": "828-894-0277",
            "fax_number": "828-894-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 LAURENS RD",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293882209",
            "telephone_number": "864-476-6600",
            "fax_number": "864-476-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MATTHEW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spartanburg County School District Four
• Spartanburg Medical Center (Medical Group of the Carolinas - Family Medicine - Woodruff)
• Andrea Kittye Stanley
• Anna M Stoudenmire, MA
• Kelsey Starr Stroud, M.ED., BCBA
• The Tribe of South Carolina Home Care LLC (The Tribe)
• Thomas Fordham Brewer MD PLLC
• Shannon Leigh Tyner Thompson, BCBA
• Tiny Bubbles SLP LLC
• Jonathan Todd, M.A.

• Physical Therapist in Woodruff, SC
• Providers in Woodruff, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.