DR. STEPHEN JOHN SULLIVAN JR. (NPI# 1164956421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164956421 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN JOHN SULLIVAN JR. |
| Credential | PHARMD. |
| Practice Address |
5955 Zeamer Ave # 673mdg Jber AK 99506-3702 |
| Mailing Address |
280 1st St Holloman Afb NM 88330-8273 |
| Practice Telephone | 9075803012 |
| Mailing Telephone | 5755727436 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2020-03-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RP00008628 | NM | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467006056 | Stephen Clinton Sullivan | Music Therapist | 2657 1st Ave E, North Saint Paul, MN 55109-3304 | 2019-07-31 |
| 1639406283 | Stephen Sullivan | Specialist | 65 Orchard Ave, Middletown, RI 02842-5842 | 2009-11-03 |
| 1447373048 | Stephen Adams Sullivan | Dentist | 1218 W. Hwy. 11, Whitewright, TX 75491-0788 | 2007-04-09 |
| 1780754556 | Stephen Joseph Sullivan Jr. | Chiropractor | 4432 E Bristol Rd, Trevose, PA 19053-4758 | 2006-11-09 |
| 1154412906 | Stephen R Sullivan | Plastic Surgery | 300 Mount Auburn St Ste 304, Cambridge, MA 02138-5665 | 2006-09-27 |
| 1083714125 | Stephen E. Sullivan IIi | Dentist | 160 Cracker Barrel Dr, Batesville, MS 38606-3031 | 2006-09-25 |
| 1376641779 | Stephen Gene Sullivan | Psychiatry & Neurology | 533 East 13th Street, Apt Ga, New York, NY 10009 | 2006-09-20 |
| 1790391928 | Stephen Sullivan | Behavior Technician | 4526 Federal Ave, Everett, WA 98203-2132 | 2020-09-22 |
| 1891738597 | Stephen P Sullivan | Psychiatry & Neurology | Nymc, Behavioral Health Center N312, Valhalla, NY 10595 | 2006-06-13 |
| 1033158530 | Stephen Sullivan | Neurological Surgery | 1500 East Medical Center Dr, 2nd Floor Taubman Ctr Recp G, Ann Arbor, MI 48109-5338 | 2006-06-06 |
| Street Address |
5955 ZEAMER AVE # 673MDG |
| City | JBER |
| State | AK |
| Zip Code | 99506-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275888943 | Cleo Patrick | Social Worker | 5955 Zeamer Ave # 673mdg, Jber, AK 99506-3702 | 2012-07-19 |
| 1841769668 | Trisha E Gibbons | Physician Assistant | 5955 Zeamer Ave # 673mdg, Jber, AK 99506-3702 | 2018-11-21 |
| 1235624008 | Nicole Elizabeth Nowling | Optometrist | 5955 Zeamer Ave # 673mdg, Jber, AK 99506-3702 | 2018-06-25 |
| 1861897746 | Karen Rose Kelly | Social Worker | 5955 Zeamer Ave # 673mdg, Jber, AK 99506-3702 | 2014-11-04 |
| 1699193979 | Tyson Hickle | Emergency Medicine | 5955 Zeamer Ave # 673mdg, Jber, AK 99506 | 2014-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538797279 | Mark Pulver | Social Worker | 673mdg, Zeamer Avenue, Joint Base Elmendorf-richardson, AK 99506 | 2020-03-30 |
| 1871052837 | Ryan Kenny Zarnowski | Dentist | 673 Mdg, 5955 Zeamer Avenue, Jber, Ak 99506, Apo, AA 99506 | 2019-03-18 |
| 1679056659 | Bennett Robert Stadler | Physician Assistant | 673 Mdg 5955 Zeamer Avenue, Jber, AK 99506 | 2018-09-14 |
| 1437678687 | Mary Ann Barnard | Nurse Practitioner | Joint Base Elmendorf-richardson Hospital, 5955 Zeamer Ave, Anchorage, AK 99506 | 2017-09-19 |
| 1205375698 | Kuuipo Lau | Social Worker | 673d Mdg, 5955 Zeamer Ave., Jber, AK 99506 | 2017-02-17 |
| 1427434315 | Vance Knauer | Dentist | 673mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-08-03 |
| 1295112159 | Jacob Eby | Pediatrics | 673 Mdg 5955 Zeamer Ave, Jber, AK 99506 | 2015-04-29 |
| 1174956338 | Scott M Cheney | Physical Therapist | 673mdg, 5955 Zeamer Ave, Jber, AK 99506 | 2013-08-12 |
| 1518305580 | Jennifer Lynn Robison | Physician Assistant | 65955 Zeamer Avenue, Jber, AK 99506 | 2013-06-12 |
| 1588939664 | Paul Aaron Garrett | Emergency Medicine | 673rd Mdg, 5955 Zeamer Avenue, Jber, Apo, AA 99506 | 2012-03-21 |
| Find all providers in zip 99506 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114263167 | Brian D Schilling | Pharmacist | Pcc Pharmacy, 4320 Diplomacy Dr, Anchorage, AK 99508-5925 | 2012-12-19 |
| 1093366601 | Heather Heidorn | Pharmacist | 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2019-09-25 |
| 1861043564 | Ashley Lourilea Hunsucker | Pharmacist | 700 Chief Eddie Hoffman Highway, Bethel, AK 99559 | 2019-09-24 |
| 1356990808 | Philip Quintero | Pharmacist | 1501 Huffman Rd, Anchorage, AK 99515-3596 | 2019-09-07 |
| 1780169094 | Michael Kristopher Frazier | Pharmacist | 1201 N Muldoon Rd, Anchorage, AK 99504-6104 | 2018-10-02 |
| 1932682127 | Devin Benjamin Drummond | Pharmacist | 1000 Greg Kruschek Ave, Nome, AK 99762 | 2018-09-13 |
| 1609379726 | Michael Bolan | Pharmacist | 4076 Neely Road, Fort Wainwright, AK 99709 | 2018-03-15 |
| 1093244287 | Lauren Elizabeth Kaleta | Pharmacist | 106 Lincoln St, Sitka, AK 99835-7540 | 2017-06-09 |
| 1346608445 | Allorie Timon Caldwell | Pharmacist | 3200 Providence Dr, Anchorage, AK 99508-4615 | 2016-02-03 |
| 1366851008 | Monika Maltese | Pharmacist | 1201 N Muldoon Rd, Anchorage, AK 99504-6104 | 2014-08-07 |
| Find all providers with the same taxonomy | ||||
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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.