Individual provider Active NPI

David E. Sullivan, M.D.

  • Emergency Medicine Physician
  • Reno, NV
National Provider Identifier
1336249283
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
10700 Issued in NV
Practice address
235 W 6TH St
Reno, NV 89503-4548
Phone
(775) 746-3202
Fax
(775) 746-1904
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 10700 NV Primary

Addresses

Primary practice location

235 W 6TH St
Reno, NV 89503-4548

Mailing address

PO Box 21418
Reno, NV 89515-1418
Phone (775) 746-3202

Other identifiers 1

IdentifierTypeStateIssuer
100502175MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20040401001633 NV Practitioner - Emergency Medicine 3173515749 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Reno Emergency Physicians Association, PLLC Emergency Medicine CurrentSince Jan 1, 2004 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince May 26, 2022 Accepting new patients
Nevada Emergency Physicians PLLC Emergency Medicine CurrentSince May 26, 2022 Accepting new patients
Olympia Emergency Services, PLLC Emergency Medicine PastSince May 12, 2024 Accepting new patients
CTH Physicians Clinic Past Accepting new patients
Carson Tahoe Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

6500 Longley Ln
Reno, NV 89511
Phone (775) 331-7000

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1336249283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21418",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895151418",
            "telephone_number": "775-746-3202",
            "fax_number": "775-746-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W 6TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034548",
            "telephone_number": "775-746-3202",
            "fax_number": "775-746-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DAVID",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "10700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502175",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.