DR. JEREMY TYSON SULLIVAN (NPI# 1053379644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053379644 |
| Entity Type | Individual |
| Full Name | DR. JEREMY TYSON SULLIVAN |
| Credential | M.D. |
| Practice Address |
10601 Winterwood Carmel IN 46032-8258 |
| Practice Telephone | 6154783720 |
| Mailing Telephone | 6154783720 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-10-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 35131 | TN | Other Service Providers |
| Y | 207R00000X | Internal Medicine | 01066525A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3865060 | 05 | |
| FEDERAL DEA NUMBER | BS7284021 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184151730 | Jeremy Isaiah Sullivan | Hospitalist | 150 55th St, Brooklyn, NY 11220-2508 | 2017-05-15 |
| 1043441306 | Jeremy Ray Sullivan | Psychologist | 655 Main St, Bennington, VT 05201-2870 | 2009-08-05 |
| 1528197985 | Jeremy James Sullivan | Physical Therapist | 801 Kings Hwy N, Fox Rehabilitation Services, Cherry Hill, NJ 08034-1513 | 2007-03-03 |
| Street Address |
10601 WINTERWOOD |
| City | CARMEL |
| State | IN |
| Zip Code | 46032-8258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235769662 | Sharon M.b. Tedder | Counselor | 1980 E. 116th St., Suite 220, Carmel, IN 46032 | 2020-01-24 |
| 1144869983 | Genesia Simmons | Occupational Therapy Assistant | 118 Medical Drive, Carmel, Indiana, OH 46032 | 2019-12-26 |
| 1962069088 | Dei of Indiana, Inc. | Optometrist | 3985 W. 106th Street, Suite 120, Carmel, IN 46032 | 2019-05-23 |
| 1427518737 | Ayesha Kias | Physical Therapist | Lifespan Therapy, 118 Medical Drive, Carmel, IN 46032 | 2019-03-22 |
| 1104305952 | Megan Nicole Neitling | Counselor | 600 E Carmel Dr Ste 146, Carmel, IN 46032 | 2018-08-13 |
| 1154817427 | Open Doors Counseling and Consulting LLC | Nurse Practitioner | 11495 N Pennsylvania, Suite 105, Carmel, IN 46032 | 2018-07-10 |
| 1326533837 | Emily Jo Hardy | Physical Therapy Assistant | Lifespan Therapy 118 Medical Drive, Carmel, IN 46032 | 2018-06-27 |
| 1770086845 | Erin Reagan | Occupational Therapist | 1118 Havest Ct., Carmel, IN 46032 | 2018-03-14 |
| 1356859748 | Maricelia Serrano | Physical Therapy Assistant | Lifespan Therapy, 118 Medical Drive, Carmel, IN 46032 | 2018-01-19 |
| 1417472234 | Leigh Anne Rozsas | Pharmacist | 1424 S Rangeline Road, Carmel, IN 46032 | 2017-08-14 |
| Find all providers in zip 46032 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521665 | Rasha Morad, Md | Internal Medicine | 7020 Valley Greens Dr Apt 16, Carmel, CA 93923-7907 | 2020-09-01 |
| 1932614062 | Emd Live LLC | Internal Medicine | 1955 Chelmsford St, Carmel, IN 46032-4456 | 2017-12-12 |
| 1902270374 | Roger Newton | Internal Medicine | 25750 Tierra Grande Dr, Carmel, CA 93923-8418 | 2015-11-21 |
| 1275938870 | Deming Mi | Internal Medicine | 11911 N Meridian St Ste 190, Carmel, IN 46032 | 2014-10-27 |
| 1144639915 | Indy House Calls | Internal Medicine | 3677 Gould Dr, Carmel, IN 46033-4750 | 2014-08-06 |
| 1700178597 | David Mitchell Lauck | Internal Medicine | 11911 N Meridian St Ste 100, Carmel, IN 46032-6919 | 2011-05-11 |
| 1174835094 | John Alan Lucich | Internal Medicine | 13845 Springmill Rd, Carmel, IN 46032-7900 | 2010-07-08 |
| 1548595879 | Alan Gelber Schwartz | Internal Medicine | 26 Cherry Hill Rd, Carmel, NY 10512-3832 | 2009-10-05 |
| 1316108418 | Andrea S Shin | Internal Medicine | 11725 N Illinois St., Ste 275, Carmel, IN 46032-3009 | 2008-06-20 |
| 1083886204 | Megan Aileen Leivant | Internal Medicine | 13296 Freehold Ct, Carmel, IN 46032 | 2008-03-27 |
| Find all providers in CARMEL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.