Active NPI
Kevin Michael Sullivan, PHARM.D.
- Pharmacist
- Elizabethtown, KY
National Provider Identifier
1366171282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 010988
- Practice address
- 913 N Dixie Ave
Elizabethtown, KY 42701-2503 - Phone
- (270) 706-1256
- Fax
- (270) 706-1258
- NPI assigned
- Jun 7, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 010988 | KY | Primary |
Addresses
Primary practice location
913 N Dixie Ave
Elizabethtown, KY 42701-2503
Mailing address
913 N Dixie Ave
Elizabethtown, KY 42701-2503
Phone (270) 706-1256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010988 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1366171282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 N DIXIE AVE",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012503",
"telephone_number": "270-706-1256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 N DIXIE AVE",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427012503",
"telephone_number": "270-706-1256",
"fax_number": "270-706-1258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KEVIN",
"middle_name": "MICHAEL",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-07",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "010988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethtown, KY
- Janet Faye Stull
- Sarah Stults
- Chad Stumpf, APSS
- Samantha Styer, LAT, ATC, NREMT
- Denis Suler, D.O
- Pamela Jeniece Sullivan
- Michelle Jackson Sumrall, MD
- Sunrise Children's Services (Jefferson Salt River Trail Region Foster Care - Elizabethtown)
- Sunrise Children's Services, Inc. (Glen Dale Center)
- Sunrise Children's Services, Inc. (Crossroads Treatment Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.