Keith Joseph Sullivan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4415 Issued in MN

Practice address

2800 Chicago Ave Ste 200
Minneapolis, MN 55407-1353

Phone

(612) 872-2700

NPI assigned

Mar 24, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Bodyworks Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Bloomington, MN
  • NPI 1992923023
  NPD (past) Authorized official
• Therapy Partners, Inc.

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1407809494

  Physical Therapist

  NPD
• Therapy Partners Inc

  • Physical Therapist
  • Forest Lake, MN
  • NPI 1821179607
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1811957889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N STE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286635",
            "telephone_number": "651-748-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CHICAGO AVE STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071353",
            "telephone_number": "612-872-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8120 Penn Avenue South",
            "address_2": "Suite 480",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554311358",
            "country_code": "US",
            "telephone_number": "952-929-7000",
            "fax_number": "952-929-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEITH",
        "middle_name": "JOSEPH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elle Sullivan, DPT
• Jenna Sullivan, MPAS, PA-C
• Kaitlin Anne Sullivan, D.D.S.
• Kathleen Ann Sullivan, LICSW
• Katie Moses Sullivan, LICSW
• Laura Sullivan
• Martha Meave Sullivan, PT
• Nadia Sullivan, LICSW
• Patsa H Sullivan, M.D.
• Tim D Sullivan, MSW, LCSW

• Physical Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.