Emily Sullivan

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

202745 Issued in MN

Practice address

4755 Foxberry Dr
Medina, MN 55340-4611

Phone

(952) 807-2519

NPI assigned

Jun 24, 2020

Last updated

Jan 10, 2023By 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 1

Addresses

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1841816907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 FOXBERRY DR",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "553404611",
            "telephone_number": "952-807-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 FOXBERRY DR",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "553404611",
            "telephone_number": "952-807-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Pool, DCM, MAC, LAC
• Eric Pressley, RT (R)
• Prlfc Care,LLC
• Adam Joel Sperl, DDS, MS
• Strengths in Motion LLC
• Gina Marie Wesley, O.D.
• Brittany Nicole West, OTR/L

• Occupational Therapy Assistant in Medina, MN
• Providers in Medina, MN by specialty
• Occupational Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.