KATIE SULLIVAN (NPI# 1730715830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730715830 |
| Entity Type | Individual |
| Full Name | KATIE SULLIVAN |
| Credential | MD |
| Practice Address |
3401 Civic Center Blvd Philadelphia PA 19104-4319 |
| Mailing Address |
3514 Lancaster Ave Apt 307 Philadelphia PA 19104-4919 |
| Practice Telephone | 2155901000 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
MD469201 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970251 | Katie Michelle Sullivan | Nurse Practitioner | 8630 Fenton St Ste 1200, Silver Spring, MD 20910-3808 | 2020-07-28 |
| 1336784628 | Katie Halleran Sullivan | Nurse Practitioner | 3919 N Maple St, Spokane, WA 99205-1349 | 2019-11-11 |
| 1033775473 | Katie Lorin Sullivan | Physical Therapist | 3947 Gulf Shores Pkwy Ste 260, Gulf Shores, AL 36542-2729 | 2019-05-10 |
| 1578022430 | Katie Sullivan | Behavior Technician | 8762 Louisiana St Ste J, Merrillville, IN 46410-7190 | 2019-03-19 |
| 1740732080 | Katie E. Sullivan | Physical Therapist | 2106 Executive Dr, Hampton, VA 23666-2402 | 2016-11-03 |
| 1649524059 | Katie Jo Sullivan | Nurse Practitioner | 8579 Commerce Dr Ste 104, Easton, MD 21601-7420 | 2012-11-07 |
| 1447543079 | Katie Marie Sullivan | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2011-05-16 |
| 1851556559 | Katie L Sullivan | Speech-Language Pathologist | 5040 E Shea Blvd, Suite 168, Scottsdale, AZ 85254-4600 | 2008-07-22 |
| 1073534863 | Katie Leigh Sullivan | Physical Therapist | 1630 Commanche Ave, Green Bay, WI 54313-6089 | 2006-07-21 |
| Street Address |
3401 CIVIC CENTER BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1932700259 | Rukhsar Karim Machiwalla | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-11-03 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1275131849 | Kelsey Ann Maher | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-15 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1891309787 | Morgan Mcmanus | Genetic Counselor, MS | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-08 |
| 1891309456 | Abigail G Stefanides | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-01 |
| 1124631247 | Abrar Khaled Alabdulhadi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-28 |
| 1003427014 | Terrence Caldwell Jr. | Pharmacist | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-13 |
| 1760093298 | Paige Emily Naschke | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891037644 | Martin Sander Polinsky | Pediatrics | 953 Caledonia St, Philadelphia, PA 19128-1129 | 2013-03-20 |
| 1265480248 | Jonathan David Heiliczer | Pediatrics | St. Christopher's Hospital for Children, Erie Avenue At Front Street, Philadelphia, PA 19134-1095 | 2006-05-04 |
| 1699319038 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1760915573 | Wendy Chiawen Hsiao | Pediatrics | 3401 Civic Center Blvd, Division of Nephrology, Philadelphia, PA 19104 | 2017-04-07 |
| 1104358449 | Dayna Mazza | Pediatrics | 3401 Civic Center Blvd, Division of Nephrology, Philadelphia, PA 19104-4319 | 2017-03-28 |
| 1336520071 | Daniella Levy-erez | Pediatrics | 3401 Civic Center Blvd, 9nw, Room 55, Philadelphia, PA 19104-4319 | 2015-06-17 |
| 1649664798 | Eric Gill Benz | Pediatrics | 3401 Civic Center Blvd, Division of Nephrology, Philadelphia, PA 19104 | 2015-03-26 |
| 1306257878 | Selasie Goka | Pediatrics | 3401 Civic Center Blvd, Division of Nephrology, Philadelphia, PA 19104 | 2014-05-18 |
| 1033555115 | Celina Veronica Brunson | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2013-05-16 |
| 1073873873 | Melissa Reba Meyers | Pediatrics | 3401 Civic Center Blvd, Division of Pediatric Nephrology, Philadelphia, PA 19104-4319 | 2012-05-25 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.