Susan Sullivan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E-7987 Issued in AR

Practice address

3101 SE 14TH St
Bentonville, AR 72712-4900

Phone

(479) 636-9234

Fax

(479) 636-0774

NPI assigned

Apr 14, 2010

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

Other names 1

• Ms. Susan Sullivan Demirel Former name

Medicare fee-for-service enrollment

Enrolled in AR

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.

• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Hospitalist Physician
  • Rogers, AR
  • NPI 1699076737
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  Pediatrics

  Medicare reassignment NPD
• Mercy Health Northwest Arkansas Communities

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Rogers, AR
  • NPI 1619219474
  NPD
• Mercy Health Northwest Arkansas Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Rogers, AR
  • NPI 1770087371
  NPD
• University of Arkansas for Medical Sciences

  • Durable Medical Equipment & Medical Supplies
  • Little Rock, AR
  • NPI 1275056004
  NPD
• Arkansas Children'S Medical Group PLLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1396274841
  NPD (past)

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154647238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-636-9234",
            "fax_number": "479-636-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-636-9234",
            "fax_number": "479-636-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Mercy Way",
            "address_purpose": "LOCATION",
            "city": "Bella Vista",
            "state": "AR",
            "postal_code": "727143000",
            "country_code": "US",
            "telephone_number": "479-636-9234",
            "fax_number": "479-876-2856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-7987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "DEMIREL",
            "middle_name": "SULLIVAN",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stretchmed
• Loren B Stringfellow, DDS
• James Stuart
• Caitlyn Sullivan
• John Thomas Sullivan, DC
• William Talley Summerlin, M.D.
• Ainsley Sumpter, ATC
• Sundrop Speech Services, PLLC
• Sunflower Speech & Feeding LLC
• Allison Tamera Sutton, APRN

• Pediatrics Physician in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.