Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberly Sullivan, PA

Individual provider Athletic Trainer · NPI 1902082456

Kimberly Sullivan, PA is a Physician Assistant in Altoona, Wisconsin. Qualified in 2016, 10 years ago. Practices with Chippewa Valley Orthopedics and Sports Medicine Clinic SC, a 30-clinician group and accepts Medicare assignment. Licensed in Oklahoma and Wisconsin.

Years since qualifying
10
Licensed in
OK, WI
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1200 Oakleaf Way Ste A
Altoona, WI 54720-2217
Phone: (715) 832-1400
Fax: (715) 832-4187
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3971 (WI)
Athletic Trainer Taxonomy 2255A2300X · Licence 466 (OK)

Record details

NPI number1902082456
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 15, 2008
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address1200 Oakleaf Way Ste A, Altoona, WI 54720-2217

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Chippewa Valley Orthopedics And Sports Medicine Clinic Sc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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