Melissa Sullivan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

52413 Issued in KY

Practice address

7982 New Lagrange Road, Suite 3
Louisville, KY 40222

Phone

(502) 657-4551

Fax

(502) 919-9001

NPI assigned

Apr 6, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seven Counties Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1598793671

  Psychiatry

  Medicare reassignment NPD
• Commonwealth of Kentucky

  • Psychiatric Hospital
  • Lexington, KY
  • NPI 1790816395
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1104211135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7982 NEW LAGRANGE ROAD, SUITE 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-657-4551",
            "fax_number": "502-919-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7982 NEW LAGRANGE ROAD, SUITE 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-657-4551",
            "fax_number": "502-919-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MELISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2021-07-14",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "52413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Na",
            "affiliation": "N",
            "address_1": "7982 New LaGrange Road, Suite 3",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaitlin Sullivan, PA-C
• Kelly G Sullivan
• Kimberly Sullivan, LCSW
• Mark F Sullivan, OD
• Meghan Sullivan, APRN
• Misty Sullivan, M.ED
• Richalle Victoria Smith Sullivan, MD
• Sarah Elaine Sullivan
• Stephanie E Sullivan, LMT
• Virginia Sullivan, LCSW, LCADC

• Psychiatry Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.