DR. MICHAEL JUDE SULLIVAN (NPI# 1326023078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326023078 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JUDE SULLIVAN |
| Credential | M.D. |
| Practice Address |
2204 Pavilion Dr Suite 108 Kingsport TN 37660-4657 |
| Practice Telephone | 4233926100 |
| Practice Fax Number | 4233926159 |
| Mailing Telephone | 4233926100 |
| Mailing Fax Number | 4233926159 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2010-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
15419 | TN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918617 | Michael David Sullivan | Social Worker | 403 1/2 Hector St, Ithaca, NY 14850-2025 | 2018-10-15 |
| 1376923292 | Michael Sullivan | Student in an Organized Health Care Education/Training Program | Walter Reed 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2015-06-05 |
| 1881074896 | Michael Gregory Sullivan | Intermediate Care Facility, Mentally Retarded | 30 Hobomack Rd, Quincy, MA 02169-2508 | 2015-06-04 |
| 1104215136 | Michael Sullivan | Perfusionist | 137 Founders Way Ct, Cape Girardeau, MO 63701-9442 | 2015-01-14 |
| 1689927915 | Michael Robert Sullivan | Pharmacist | 41 Buena Vista St, Stamford, CT 06907-2402 | 2012-10-24 |
| 1154672038 | Michael James Sullivan | Dentist | 1882 Hard Rd, Columbus, OH 43235-1996 | 2012-10-02 |
| 1063791747 | Michael Gruer Sullivan | Counselor | 2024 N. Crystal Lake Dr., Suite 200 Room 205, Lakeland, FL 33801-6015 | 2011-08-11 |
| 1457647083 | Michael Patrick Sullivan | Dentist | 1008 G Sreet, Geneva, NE 68361 | 2011-06-22 |
| 1841528585 | Michael Andrew Sullivan | Counselor | 974 73rd St Ste 9, Windsor Heights, IA 50324-1026 | 2009-11-18 |
| 1508191388 | Michael Joseph Sullivan | Audiologist | 6644 Penn Ave S, Richfield, MN 55423-2026 | 2009-10-12 |
| Street Address |
2204 PAVILION DR SUITE 108 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245226737 | Rebecca Jane Hamilton | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2005-09-21 |
| 1720468200 | Mountain States Health Alliance | General Acute Care Hospital | 2204 Pavilion Dr, Suite 115, Kingsport, TN 37660-4657 | 2015-06-01 |
| 1821402728 | Sullivan Specialty Pharmacy | Pharmacy | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2014-06-18 |
| 1568703437 | Lauren Musick | Pharmacist | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2013-03-02 |
| 1316228075 | Clinchfield Family Medicine, Pllc | Clinic/Center | 2204 Pavilion Dr, Suite 110, Kingsport, TN 37660-4657 | 2011-09-07 |
| 1619265550 | Tennessee Anesthesiology LLC | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2011-07-13 |
| 1396049938 | Blue Ridge Medical Management Corporation | Pediatrics | 2204 Pavilion Dr, Suite 210, Kingsport, TN 37660-4657 | 2010-12-22 |
| 1730401209 | Blue Ridge Medical Management Corporation | Family Medicine | 2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4653 | 2010-02-24 |
| 1518289206 | James Bradley Gaither | Nurse Anesthetist, Certified Registered | 2204 Pavilion Dr, Suite 105, Kingsport, TN 37660-4657 | 2010-02-22 |
| 1265763668 | Lauren Ambrosia Daley | Nurse Practitioner | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2010-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1700887106 | Jeffrey P Fenyves | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-09 |
| 1023338456 | Adam Wesley Coe | Internal Medicine | 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660-3847 | 2010-06-08 |
| 1003981093 | Sullivan and Ptrs | Internal Medicine | 2204 Pavilion Dr, Suite 108, Kingsport, TN 37660-4657 | 2006-11-22 |
| 1740366459 | Rathi Narayan | Internal Medicine | 135 W Ravine Rd, Ste 3a, Kingsport, TN 37660-3847 | 2006-10-27 |
| 1083639918 | Tri-cities Gastroenterology LLC | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| 1134166291 | Christopher Mark Mathews | Internal Medicine | 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660-3847 | 2006-05-31 |
| 1437134723 | Lawrence Delmore Bailey Jr. | Internal Medicine | 105 W Stone Dr, Ste 4c, Kingsport, TN 37660-3256 | 2005-12-09 |
| 1659366888 | Gerald F London | Internal Medicine | 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660-3847 | 2005-09-14 |
| 1629063813 | R. Douglas Strickland | Internal Medicine | 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660-3847 | 2005-09-14 |
| 1336134816 | Douglas J Springer | Internal Medicine | 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660-3847 | 2005-09-12 |
| Find all providers in KINGSPORT | ||||
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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.