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

Scott Sullivan

Individual provider Physical Therapist · NPI 1477070522

Scott Sullivan is a Physical Therapist in Private Practice in Lake Wylie, South Carolina. Qualified in 2017, 9 years ago. Practices with Ivyrehab Focus, Inc, a 40-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Colorado, North Carolina and South Carolina.

Years since qualifying
9
Licensed in
CO, NC, SC
In the registry since
2017
Specialties on file
3
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Practice location Address checks out

439 Channel Rd Ste 102
Lake Wylie, SC 29710-6101
Phone: (803) 746-7800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 2322 S Academy Blvd, Colorado Springs, CO 80916-2406 — (719) 390-1727
  • 5320 Mark Dabling Blvd # 100, Colorado Springs, CO 80918-3839 — (719) 592-1584
  • 2675 Court Dr, Gastonia, NC 28054-1478 — (704) 824-7800

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12553 (SC)
Physical Therapist Taxonomy 225100000X · Licence 20579 (NC)
Orthopedic Physical Therapist Taxonomy 2251X0800X · Licence PTL.0015126 (CO)

Record details

NPI number1477070522
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 29, 2017
Last updated in NPPESFebruary 7, 2025
Certification dateFebruary 7, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Ivyrehab Focus, Inc. — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Wylie