John Paul Sullivan, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

KY21704 Issued in KY

Practice address

4011 Gardiner Point Dr Ste 101
Louisville, KY 40213-1988

Phone

(502) 451-5121

Fax

(502) 451-5125

NPI assigned

Jul 27, 2006

Last updated

Jan 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Psychiatry

Education

University of Louisville School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sullivan Psychiatric Group, PLLCGroup PAC ID 4486913530, 3 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sullivan Psychiatric Group, PLLC

  • Child & Adolescent Psychiatry Physician
  • Louisville, KY
  • NPI 1366879025
  Medicare reassignment Care Compare group NPD Authorized official
• John P Sullivan MD

  • Child & Adolescent Psychiatry Physician
  • Louisville, KY
  • NPI 1285519504
  Authorized official Same address or phone
• Uofl Health-Louisville Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1639711294
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1356355531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 GARDINER POINT DR STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131988",
            "telephone_number": "502-451-5121",
            "fax_number": "502-451-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 GARDINER POINT DR STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402131988",
            "telephone_number": "502-451-5121",
            "fax_number": "502-451-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "KY21704",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KY",
            "license": "KY21704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64217045",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100012920A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Izabella Sullivan, APRN
• Janice Elaine Sullivan, MD
• Jessica Sullivan
• Joeli Rae Sullivan
• John F. Sullivan, MD
• Kaitlin Sullivan, PA-C
• Kelly G Sullivan
• Kimberly Sullivan, LCSW
• Mark F Sullivan, OD
• Meghan Sullivan, APRN

• Child & Adolescent Psychiatry Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Child & Adolescent Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.