JONATHON C. SULLUM (NPI# 1225041536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225041536 |
| Entity Type | Individual |
| Full Name | JONATHON C. SULLUM |
| Credential | M.D. |
| Practice Address |
2601 Stafford Avenue Scranton PA 18505-0305 |
| Mailing Address |
2601 Stafford Avenue Po Box 3305 Scranton PA 18505-0305 |
| Practice Telephone | 5703466633 |
| Mailing Telephone | 5703466633 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD020198E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0006585310012 | 05 | |
| PA | GEISINGER HEALTH PLAN | 10624 1686 | 01 |
| PA | RAILROAD MEDICARE | 300020246 | 01 |
| PA | THREE RIVERS | 000000083999 | 01 |
| PA | HIGHMARK BLUE SHIELD | 141629 | 01 |
| PA | 0004210397 | 0004210397 | 01 |
| PA | AMERIHEALTH MERCY | 20007413 | 01 |
| PA | BLUE CROSS | C31604 | 01 |
| Street Address |
2601 STAFFORD AVENUE |
| City | SCRANTON |
| State | PA |
| Zip Code | 18505-0305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952927998 | Gary Chee Seng Oh | Student in an Organized Health Care Education/Training Program | 501 S. Washintgon Avenue, Scranton, PA 18505 | 2020-06-24 |
| 1851915813 | Usman Amjia Manzoor | Student in an Organized Health Care Education/Training Program | 501 South Washintgon Avenue, Scranton, PA 18505 | 2020-06-04 |
| 1396368791 | Navharsh Kaur Sekhon | Student in an Organized Health Care Education/Training Program | 501 S, Washington Avenue, Scranton, PA 18505 | 2020-05-20 |
| 1275154395 | Yamini Indravadan Patel | Student in an Organized Health Care Education/Training Program | 501 South Washington Avenue The Wright Center for Gradu, 501 South Washington Avenue, Scranton, PA 18505 | 2020-04-29 |
| 1225659584 | Raza Naseer | Student in an Organized Health Care Education/Training Program | 501 S. Washington Avenue, Scranton, PA 18505 | 2020-04-28 |
| 1932720307 | Mohammad Asim Amjad | Student in an Organized Health Care Education/Training Program | 501 South Washington Avenue, Scranton, PA 18505 | 2020-04-27 |
| 1033739404 | Amina Khan | Student in an Organized Health Care Education/Training Program | 501 S Washington Avenue, Scranton, PA 18505 | 2020-04-25 |
| 1245862259 | Princy Kanakkumar Shah | Internal Medicine | Wright Medical Center, 501 S Washington Avenue, Scranton, PA 18505 | 2020-02-07 |
| 1902363005 | Keystone Community Resources, Inc. | Day Training/Habilitation Specialist | 628 Genet Street, Scranton, PA 18505 | 2019-02-25 |
| 1629596242 | Morgan Aubrey Yackey | Social Worker | 1509 Maple St., Scranton, PA 18505 | 2017-09-04 |
| Find all providers in zip 18505 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033511621 | Geisinger Clinic | Radiology | 5 Morgan Highway, Suite 7, Scranton, PA 18508 | 2014-09-25 |
| 1558340448 | Mark Skevofilax | Radiology | 435 Scranton Carbondale Hwy, Scranton, PA 18508-1115 | 2006-01-10 |
| 1700865680 | Jeffrey T Blum | Radiology | 435 Scranton Carbondale Highway, Scranton, PA 18508 | 2006-01-10 |
| 1801875786 | Gerald Larar | Radiology | 435 Scranton-carbondale Highway, Scranton, PA 18508 | 2006-01-10 |
| 1962495374 | Charles N. Barax | Radiology | 613 N Webster Ave, Scranton, PA 18510-1808 | 2005-08-31 |
| 1477931582 | Charles S. Sutton, M.d.,p.c. | Radiology | 3 W Olive St, Suite 220, Scranton, PA 18508-2572 | 2015-05-08 |
| 1942602537 | Geisinger Clinic | Radiology | 475 Morgan Highway, Scranton, PA 18508 | 2014-09-25 |
| 1609283290 | Geisinger Clinic | Radiology | 435 Scranton Carbondale Hwy, Scranton, PA 18508-1115 | 2014-07-16 |
| 1689093718 | Towhid Ali | Radiology | 1800 Mulberry St, Scranton, PA 18510-2369 | 2014-04-16 |
| 1356598817 | Diagnostic Imaging Centers of Nepa, LLC | Radiology | 1789 N Keyser Ave, Scranton, PA 18508-1250 | 2008-08-26 |
| Find all providers in SCRANTON | ||||
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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.