STEPHEN SULLMAN (NPI# 1639519747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639519747 |
| Entity Type | Individual |
| Full Name | STEPHEN SULLMAN |
| Credential | RPH |
| Practice Address |
2200 E Show Low Lake Rd Show Low AZ 85901-7831 |
| Practice Telephone | 9285376321 |
| Practice Fax Number | 9285377814 |
| Mailing Telephone | 9285376321 |
| Mailing Fax Number | 9285377814 |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2013-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
S013199 | AZ | Pharmacy Service Providers |
| Street Address |
2200 E SHOW LOW LAKE RD |
| City | SHOW LOW |
| State | AZ |
| Zip Code | 85901-7831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054154 | David Kies | Anesthesiology | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7881 | 2005-06-27 |
| 1568089787 | Austin Johnson | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2020-07-03 |
| 1477104552 | Summit Healthcare Association | Psychiatric Unit | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2019-09-20 |
| 1174187546 | Constance L Collman | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2019-04-30 |
| 1912463084 | Sophie Shizuyo Jessop | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2019-02-14 |
| 1851870919 | Mary Jane Wild Sorenson | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2018-08-09 |
| 1235641382 | Nicolette Broby | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-10-30 |
| 1689184616 | Chasen Kenneth Halcomb | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-10-04 |
| 1255859567 | Shane Mcbride Smith | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-09-07 |
| 1780109710 | Tina Jean Palone | Nurse Practitioner | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811468804 | Summit Healthcare Association | Pharmacy | 4951 South White Mountain Road, Bldg A., Suite 1500, Show Low, AZ 85901 | 2018-12-17 |
| 1821446386 | Ivy L Loney | Social Worker | 580 E. Old Linden Rd #6, Show Low, AZ 85901 | 2016-05-25 |
| 1750749214 | Summit Healthcare | General Acute Care Hospital | 181 East Sylvester, Show Low, AZ 85901 | 2016-01-29 |
| 1194153916 | Alpha & Omega Physical Therapy Acc | Physical Therapist | 861 E Cooley St # B, Show Low, AZ 85901 | 2013-10-15 |
| 1033454707 | North Country Healthcare, Inc. | Family Medicine | 2600 E. Show Low Lake Rd., Show Low, AZ 85901 | 2012-12-06 |
| 1073740098 | North Country Healthcare, Inc. | Clinic/Center | 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 | 2009-06-17 |
| 1215174768 | Coast To Coast Air Ambulance, LLC | Ambulance | 3151 Airport Loop Ste 2, Show Low, AZ 85901 | 2009-01-20 |
| 1487899712 | Akdhc, LLC | Internal Medicine | 2051 Evergreen Lane, Ste D, Your Family Practice Team, Show Low, AZ 85901 | 2008-12-16 |
| 1851553192 | Health Angels Companion Care, Inc. | Technician | 1001 E. Huning, Show Low, AZ 85901 | 2008-06-27 |
| 1528231586 | Peggy Johnson | Occupational Therapist | Cusd# 24 Hwy 191, Chinle, AZ 85901 | 2008-04-10 |
| Find all providers in zip 85901 | ||||
| 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 |
|---|---|---|---|---|
| 1306202791 | Michael Edward Roman | Pharmacist | 1240 N 40th Dr, Show Low, AZ 85901-3236 | 2016-01-14 |
| 1982173993 | Camille Wasiak | Pharmacist | 5160 S White Mountain Rd, Show Low, AZ 85901-7826 | 2018-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169563 | Nosayawe Edokpayi | Pharmacist | Indian Health Service/ Hopi Health Care Center, Highway 264 Mile Post 388, Polacca, AZ 86042-4000 | 2020-09-23 |
| 1922639905 | Lana Druzhinin Bohon | Pharmacist | 5249 E Shea Blvd Unit 208, Scottsdale, AZ 85254-5739 | 2020-01-29 |
| 1023593126 | Catherine Lee | Pharmacist | 220 W 6th Street Room B113, Tucson, AZ 85701 | 2018-09-25 |
| 1629557855 | Jeffrey Gubernick | Pharmacist | 7305 E Visao Dr, Scottsdale, AZ 85266-2707 | 2018-08-08 |
| 1730638214 | Tai Long Huynh | Pharmacist | 9950 W Via Del Sol, Peoria, AZ 85383-3323 | 2016-09-26 |
| 1487101028 | Marisol Ibarra | Pharmacist | 4802 N 12th St Apt 1086, Phoenix, AZ 85014-4098 | 2016-09-01 |
| 1679935332 | Tammy B Bird | Pharmacist | 617 W Havasupai Rd, Flagstaff, AZ 86001-1513 | 2016-03-22 |
| 1457719858 | John Randle House | Pharmacist | 3345 E Behrend Dr, Phoenix, AZ 85050-3983 | 2016-02-01 |
| 1043688591 | Anna Montuori | Pharmacist | 14450 N Thompson Peak Pkwy Unit 120, Scottsdale, AZ 85260-7770 | 2015-09-14 |
| 1548644396 | Alexander German | Pharmacist | 13985 W Grand Ave Ste 101, Surprise, AZ 85374-3626 | 2015-07-10 |
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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.