DR. GERALD EDWARD SULLIVAN (NPI# 1760683551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760683551 |
| Entity Type | Individual |
| Full Name | DR. GERALD EDWARD SULLIVAN |
| Credential | M.D. |
| Practice Address |
6040 W Lisbon Ave Suite 200 Milwaukee WI 53210-2116 |
| Mailing Address |
1169 N 13th Ave West Bend WI 53090-1701 |
| Practice Telephone | 4144479890 |
| Practice Fax Number | 4144479891 |
| Mailing Telephone | 2623061997 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 37202 | WI | Allopathic & Osteopathic Physicians |
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
37202 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32475500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376613737 | Gerald Eugene Sullivan | Ophthalmology | 730 Fairview Ave, Suite B1, Bowling Green, KY 42101-2367 | 2006-11-09 |
| 1588177497 | Gerald Dwight Sullivan | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-11-14 |
| 1851844039 | Gerald P. Sullivan | Counselor | 8 Farnham St, Boston, MA 02119-2908 | 2016-07-25 |
| 1992921662 | Gerald Michael Sullivan | Psychologist | 228 E Northwest Hwy, Palatine, IL 60067-8107 | 2007-04-18 |
| 1154396927 | Gerald Bland Sullivan | Family Medicine | 7 Kennedy Dr, Putnam, CT 06260-1939 | 2006-02-23 |
| Street Address |
6040 W LISBON AVE SUITE 200 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53210-2116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902869290 | Nancy Hall | Counselor | 6040 W Lisbon Ave, Suite 102, Milwaukee, WI 53210-2116 | 2006-04-08 |
| 1033626338 | Colleen Runge | Counselor | 6040 W Lisbon Ave, Milwaukee, WI 53210-2116 | 2018-01-08 |
| 1043751902 | Rec Enterprise LLC | Case Management | 6040 W Lisbon Ave, Ste B6, Milwaukee, WI 53210-2116 | 2017-03-12 |
| 1437608734 | Active Home Care, LLC | Home Health | 6040 W Lisbon Ave, Suite 104, Milwaukee, WI 53210-2116 | 2016-09-27 |
| 1124475124 | Jessica Bohmann | Counselor | 6040 W Lisbon Ave, Milwaukee, WI 53210-2116 | 2016-05-19 |
| 1609296516 | Ashley Mccoy-rampson Smallwood | Counselor | 6040 W Lisbon Ave, Suite 103, Milwaukee, WI 53210-2116 | 2014-04-17 |
| 1205263159 | Sullivan Medical Clinic, LLC | Internal Medicine | 6040 W Lisbon Ave, Suite 200, Milwaukee, WI 53210-2116 | 2013-10-07 |
| 1033554373 | Our Daily Bread Community Outreach Center, Inc | Case Management | 6040 W Lisbon Ave, Suite 203, Milwaukee, WI 53210-2116 | 2013-04-30 |
| 1700125622 | Acacia Mental Health | Intermediate Care Facility, Mental Illness | 6040 W Lisbon Ave, Milwaukee, WI 53210-2116 | 2013-02-13 |
| 1164760054 | Terri Lynn Walker | Registered Nurse | 6040 W Lisbon Ave, Suite 102, Milwaukee, WI 53210-2116 | 2013-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499514 | Mckenzie Lisa Lambeck | Non-emergency Medical Transport (VAN) | 3016a N 36th St, Milwaukee, WI 53210 | 2020-08-31 |
| 1922572312 | Walter's Second Chance of Milwaukee, LLC. | In Home Supportive Care | 3043 N. 29th Street, Milwaukee, WI 53210 | 2019-01-18 |
| 1407353469 | Angie F Caballero | Assisted Living Facility | 5918 N 62nd Street, Milwaukee, WI 53210 | 2018-04-06 |
| 1689182636 | Kimberly Casey | Counselor | 5325 W.burleigh, Milwaukee, WI 53210 | 2018-01-11 |
| 1336663640 | Daron Mosby | Counselor | 2643 N 55th St., 2643 N 55th St., Milwaukee, WI 53210 | 2017-07-28 |
| 1881117174 | Advance Home Care, LLC | In Home Supportive Care | 6001 W Center St Ste 98ll, Milwaukee, WI 53210 | 2017-07-19 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1447625264 | Kimberly Beckham | Registered Nurse | 3040 N 40th Street, Milwaukee, WI 53210 | 2015-12-04 |
| 1033595319 | Wisconsin Lutheran Child & Family Service Inc. | Social Worker | 207 North Sherman Blvd, Milwaukee, WI 53210 | 2015-08-10 |
| 1346633112 | Quiana Davis | Licensed Practical Nurse | 2478 North 34th Street, Milwaukee, WI 53210 | 2015-03-18 |
| Find all providers in zip 53210 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1639617665 | Edward Min Chi | Internal Medicine | 2320 N Lake Dr Ste 3603, Milwaukee, WI 53211-4507 | 2017-02-09 |
| 1750743159 | Andrew Charles Rose | Internal Medicine | 999 N 92nd St Ste 730, Milwaukee, WI 53226-4875 | 2016-03-24 |
| 1942694401 | Iryna Nemesh | Internal Medicine | 1020 N 12th St Fl 2, Milwaukee, WI 53233 | 2015-03-23 |
| 1376955492 | Ashish Chaddha | Internal Medicine | 900 North 92nd Street, Milwaukee, WI 53226 | 2014-05-22 |
| 1518305671 | Aishah Aslam | Internal Medicine | 3070 N 51st St Ste 106, Milwaukee, WI 53210-1661 | 2013-06-11 |
| 1578822318 | Joel S Weiner | Internal Medicine | 720 E Wisconsin Ave, 2w440, Milwaukee, WI 53202-4703 | 2012-05-14 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1467731570 | Valena Grbic | Internal Medicine | 2311 N Prospect Avenue, Milwaukee, WI 53211 | 2011-08-06 |
| 1629396965 | Catherine A Kim | Internal Medicine | 3003 W Good Hope Rd Bldg 1642nd, Milwaukee, WI 53209-2042 | 2010-05-11 |
| 1730402892 | Robert Anthony Kebbekus | Internal Medicine | 8200 Warren Ave, Milwaukee, WI 53213-2124 | 2010-03-03 |
| Find all providers in MILWAUKEE | ||||
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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.