MADELINE KLAIRE SULLIVAN (DPT) – Physical Therapist, NPI 1831882976

MADELINE KLAIRE SULLIVAN (DPT) is a healthcare provider. based in Mendenhall, Mississippi. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT7542 (MS). The NPI Number for MADELINE KLAIRE SULLIVAN (DPT) is 1831882976

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MADELINE KLAIRE SULLIVAN (DPT)
NPI
1831882976
Phone
(601) 847-2221
Address
1842 Simpson Highway 149
Enumeration Date
2 June 2023
Last Update Date
2 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6018918179
Graduation Year
2023 (3 years ago)
PAC ID
0244751857
Group Practice PAC ID
7012971047
Professional Enrollment ID
I20250311001864
Address ID
MS390739523FL2990XSXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:3State licenses:1Digital endpointsOther names

769 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MS

Provider Addresses for MADELINE KLAIRE SULLIVAN (DPT)

  • 1842 Simpson Highway 149

    Mendenhall, MS 391143438

    Phone: (601) 847-2221

    Type: Location

  • 1408 VICTORIA LN

    BRANDON, MS 390426089

    Phone:

    Type: Mailing

  • 300 3RD AVE SE

    MAGEE, MS 391113665

    Phone: (601) 849-5070

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250311001864IPhysical Therapist In Private PracticeMSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 39114)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012971047View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS
Qualified Speech Language PathologistMS
Physical Therapist In Private PracticeMS
Occupational Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS
Physical Therapist In Private PracticeMS

Reviews

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Frequently asked questions

Is there an official ID for MADELINE KLAIRE SULLIVAN (DPT) in U.S. healthcare records?
The official identifier for MADELINE KLAIRE SULLIVAN (DPT) is NPI 1831882976.
Is MADELINE KLAIRE SULLIVAN (DPT) still an active registrant?
MADELINE KLAIRE SULLIVAN (DPT) carries an active NPI according to the public dataset.
How would a patient describe MADELINE KLAIRE SULLIVAN (DPT)'s focus?
For MADELINE KLAIRE SULLIVAN (DPT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Is MADELINE KLAIRE SULLIVAN (DPT) located near Mendenhall?
MADELINE KLAIRE SULLIVAN (DPT) currently maps to Mendenhall, Mississippi in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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