MICHAEL JOHN SULLIVAN (NPI# 1780043463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780043463 |
Entity Type | Individual |
Full Name | MICHAEL JOHN SULLIVAN |
Credential | AGANP-C |
Practice Address |
705 Dixie St Suite 401 Carrollton GA 30117-3818 |
Mailing Address |
119 Ambulance Dr Suite 202 Carrollton GA 30117-3857 |
Practice Telephone | 7708369326 |
Mailing Telephone | 7708388710 |
Enumeration Date | 2016-02-23 |
Last Update Date | 2016-03-02 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN209135 | GA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN209135 | GA | Physician Assistants & Advanced Practice Nursing Providers |
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 |
705 DIXIE ST SUITE 401 |
City | CARROLLTON |
State | GA |
Zip Code | 30117-3818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407848799 | Lawrence Brett Carter | Pharmacist | 705 Dixie St, Carrollton, GA 30117-3818 | 2005-08-22 |
1760007322 | Crystal Renee Grayson | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-06-10 |
1962025361 | Amanda Hasty Mcentyre | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
1265055669 | Purdy Jackson | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
1528681921 | Amanda Phillips Kranz | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
1699396630 | Katherine Victoria White | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-04-30 |
1144866047 | Jennifer Tiffany Jiles | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-11-26 |
1750934733 | Tiffany Landry | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
1104479195 | Kim Rowell | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
1104478916 | Brandon Gabe Graves | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
Find all providers in zip 30117 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194203851 | Laura Marie Fessler | Nurse Practitioner | 2300 Marsh Ln Apt 214, Carrollton, TX 75006-4852 | 2018-08-03 |
1417458498 | Larrice Tela Gorley | Nurse Practitioner | 174 Emerald Pointe Dr, Carrollton, GA 30116-9409 | 2018-02-23 |
1851733679 | Angela M Rogers | Nurse Practitioner | 100 Professional Pl Ste 310, Carrollton, GA 30117-3872 | 2013-07-22 |
1326676206 | Jessica Danielle Spears | Nurse Practitioner | 4343 N Josey Ln, Carrollton, TX 75010-4603 | 2020-03-27 |
1659907160 | Angelita Ancheta Parrish | Nurse Practitioner | 2340 E Trinity Mills Rd Ste 250, Carrollton, TX 75006-1946 | 2020-03-16 |
1558876524 | Savannah Bryanna Jackson | Nurse Practitioner | 100 Professional Pl Ste 204, Carrollton, GA 30117-3802 | 2017-12-12 |
1689045957 | Kelsey Elizabeth Reekie | Nurse Practitioner | 4240 International Pkwy, Suite 154, Carrollton, TX 75007-1970 | 2015-10-13 |
1588079248 | Emily Tarpley Massey | Nurse Practitioner | 157 Clinic Ave Ste 203, Carrollton, GA 30117-4454 | 2014-06-20 |
1093956351 | Melanie Sims | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2009-03-17 |
1881818854 | Tracy Lynn Brown | Nurse Practitioner | 4325 N Josey Ln, Plaza 2 Suite 301, Carrollton, TX 75010-4635 | 2007-04-12 |
Find all providers in CARROLLTON |
City | CARROLLTON |
Zip Code | 30117 |
Please comment or provide details below to improve the information on MICHAEL JOHN SULLIVAN.
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.