DR. JILLIAN E SULLIVAN (NPI# 1114357506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114357506 |
| Entity Type | Individual |
| Full Name | DR. JILLIAN E SULLIVAN |
| Credential | PH.D., HSPP |
| Practice Address |
3000 S State Road 135 Suite 230 Greenwood IN 46143-9607 |
| Mailing Address |
6626 E 75th Street Suite 500 Indianapolis IN 46250-2890 |
| Practice Telephone | 3175350728 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
20042704A | IN | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
20042704A | IN | Behavioral Health & Social Service Providers |
| Y | 103TH0004X |
Psychologist Specialization: Health |
20042704A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM BCBS | 000000850729 | 01 |
| IN | RAILROAD PTAN | P01569147 | 01 |
| IN | RR MEDICARE | P01569147 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144554981 | Jillian Elizabeth Sullivan | Licensed Practical Nurse | 106 Tuller Rd, Front, North Syracuse, NY 13212-1624 | 2009-09-27 |
| 1669969549 | Jillian C Sullivan | Community Health Worker | 3506 Kennett Pike, Wilmington, DE 19807-3019 | 2018-04-17 |
| 1346761095 | Jillian Sullivan | Pharmacist | 1 Tampa General Cir, Tampa, FL 33606-3571 | 2017-07-03 |
| 1639423734 | Jillian Ann Sullivan | Nurse Practitioner | 263 Farmington Ave, Internal Medicine, Farmington, CT 06030-2212 | 2012-10-29 |
| 1265560809 | Jillian Sarah Sullivan | Pediatrics | 111 Colchester Ave, Burlington, VT 05401-1473 | 2007-03-02 |
| Street Address |
3000 S STATE ROAD 135 SUITE 230 |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-9607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144250689 | David K Booth II | Family Medicine | 3000 S State Road 135, Suite 310, Greenwood, IN 46143-9825 | 2006-07-03 |
| 1386259786 | Amanda Jo Pantone | Dietitian, Registered | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2020-09-11 |
| 1144889486 | Jamie Marie Wallace | Physical Therapist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2019-06-11 |
| 1376029223 | Jordan Lee Clark | Pharmacist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2018-07-13 |
| 1649786765 | Chelsea Angelo | Speech-Language Pathologist | 3000 S State Road 135, Greenwood, IN 46143-9825 | 2017-12-27 |
| 1174066856 | Andrew Keith Roark | Physical Therapist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-11-29 |
| 1982054771 | Kiersten Hunter | Speech-Language Pathologist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-06-13 |
| 1992164297 | Jacqueline Fleagle | Physical Therapist | 3000 S State Road 135, Suite 110, Greenwood, IN 46143-9825 | 2016-02-15 |
| 1629407754 | Heidi Jo Coppess | Physical Therapist | 3000 S State Road 135, Greenwood, IN 46143-9607 | 2013-11-08 |
| 1376972844 | Laura Fikes | Occupational Therapist | 3000 S State Road 135, Greenwood, IN 46143-9607 | 2013-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 103TH0004X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health |
| The distinct focus of the clinical health psychologist is on physical health problems. A clinical health psychologist has special expertise or training in clinical health psychology and applies scientific knowledge of the interrelationships among behavioral, emotional, cognitive, social and biological components in health and disease to the promotion and maintenance of health; the prevention, treatment and rehabilitation of illness and disability; and the improvement of the health care system. Clinical health psychologists are dedicated to the development of knowledge regarding the interface between behavior and health, and to the delivery of high quality services based on that knowledge to individuals, families, and health care. |
| Notes: Source: American Psychological Association Commission for the Recognition of Specialties and Proficiencies in Professional Psychology, 2008. [1/1/2007: new, 7/1/2008: definiton added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508349051 | Suzanne Marie Wiley | Psychologist | 607 Ironwood Ln, Anderson, IN 46011-1651 | 2018-09-11 |
| 1952600413 | Kevin Jordan | Psychologist | 450 N 7th St, Root Hall, Terre Haute, IN 47809-1928 | 2011-03-23 |
| 1013240738 | Yelena Chernyak | Psychologist | 550 University Blvd, Room Uh 3240, Indianapolis, IN 46202-5149 | 2009-09-14 |
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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.