Nancy Sullivan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60187 Issued in OR

Practice address

1040 NW 22ND Ave
Suite 520
Portland, OR 97210-3057

Phone

(503) 413-7556

Fax

(503) 413-6547

NPI assigned

Oct 25, 2006

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Kirsten E Dumford

  • Physical Therapist
  • Petaluma, CA
  • NPI 1669660833
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1811071863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103097",
            "telephone_number": "503-413-7556",
            "fax_number": "503-413-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-413-7556",
            "fax_number": "503-413-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NANCY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12501",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON PHYSICAL THERAPY LICENSE",
            "identifier": "60187",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisa Katherine Long Sullivan, PHARMD
• Mary Lou Sullivan, MA COUNSELING MFCC
• Maura D. Sullivan, PSY.D.
• Michael Sullivan, PH.D.
• Michele Kathleen Sullivan, MPT
• Nancy H Sullivan, CNM
• Patricia Sullivan
• Patricia Anne Sullivan, DMD
• Peter Damian Sullivan, MD
• Richard John Sullivan, LMT

• Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.