Kathleen Sullivan, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A62975 Issued in CA

Practice address

194 Cohasset Rd
Chico, CA 95926-2202

Phone

(530) 893-2303

Fax

(530) 893-3607

NPI assigned

Jun 24, 2005

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Interoperability endpoints

• Direct secure messaging: ksullivan237916@hisp.ehr.sutterhealth.org
• Direct secure messaging: ksullivan15466@enloedirect.org

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.

• Enloe Health and Wellness

  • Pediatrics Physician
  • Chico, CA
  • NPI 1053122010
  NPD (past)
• Enloe Health and Wellness

  • Primary Care Clinic/Center
  • Chico, CA
  • NPI 1740922426
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1245236199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 COHASSET RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262202",
            "telephone_number": "530-893-2303",
            "fax_number": "530-893-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 COHASSET RD",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262202",
            "telephone_number": "530-893-2303",
            "fax_number": "530-893-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A62975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A629750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Christine Studivent
• Michael Emily Sturr
• Thomas Alexander Suberman, MD
• Ramaswamy Tirunellai Subramanian
• Suk Young Ahn DDS Inc
• Kimberly Marie Sullivan
• Kyla Super
• Nanci Jane Surber, PTA
• Daniel D Surh, D.M.D.
• Luke Surminsky

• Pediatrics Physician in Chico, CA
• Providers in Chico, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.