Laura E. Sullivan, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

17429 Issued in NV

Practice address

1500 E 2ND St Ste 400
Reno, NV 89502-1198

Phone

(775) 982-2400

Fax

(775) 982-2888

NPI assigned

Jun 18, 2008

Last updated

May 28, 2024By the provider in NPPES

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 2

Other names 1

• Laura Ellen Jack Former name

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Nevada School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians

Simonmed Reno PLLCGroup PAC ID 5991140360, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
• Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049
• Carson Valley Health Hospital, Gardnerville, NV, CCN 291306
• Banner Lassen Medical Center Hospital, Susanville, CA, CCN 051320
• Tahoe Forest Hospital Hospital, Truckee, CA, CCN 051328

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsullivan124536@direct.renown.org

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.

• Community Care Services LLC

  dba Community Care Services

  • Internal Medicine Physician
  • Reno, NV
  • NPI 1720031768

  CA

  Medicare reassignment Care Compare group NPD
• Simonmed Reno PLLC

  dba Reno Diagnostic Center

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1306576145
  Medicare reassignment Care Compare group NPD
• Banner Health

  • Multi-Specialty Clinic/Center
  • Susanville, CA
  • NPI 1205267549
  Medicare reassignment NPD
• Banner Lassen Medical Center

  • Critical Access Hospital
  • Susanville, CA
  • NPI 1538197231
  Medicare reassignment NPD
• Health Diagnostics of California a Professional Corporation

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Mountain View, CA
  • NPI 1104321959

  NV

  Medicare reassignment NPD
• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Medicare reassignment NPD
• Simonmed Imaging Florida LLC

  dba Simonmed Imaging Tampa

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  NV

  Medicare reassignment NPD
• Smi Imaging, LLC

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  NV

  Medicare reassignment NPD
• Community Care Services LLC

  dba Renown Healthy Heart Program

  • Cardiac Rehabilitation Clinic/Center
  • Reno, NV
  • NPI 1295180735
  Medicare reassignment
• Community Care Services LLC

  dba Renown Medical Group Pulmonary Medicine

  • Pulmonary Disease Physician
  • Reno, NV
  • NPI 1457822132
  NPD
• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340
  NPD
• Banner Lassen Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Susanville, CA
  • NPI 1922334846
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation
• Renown South Meadows Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1720058027
  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba CVMC Outpatient Behavioral Health Clinic

  • Community/Behavioral Health Agency
  • Gardnerville, NV
  • NPI 1104482918

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba Carson Valley Health

  • Critical Access Hospital
  • Gardnerville, NV
  • NPI 1396799102
  Care Compare affiliation
• Banner Lassen Medical Center

  • Critical Access Hospital
  • Susanville, CA
  • NPI 1538197231
  Care Compare affiliation
• Tahoe Forest Hospital District

  dba Tahoe Forest Hospital

  • Critical Access Hospital
  • Truckee, CA
  • NPI 1538265780
  Care Compare affiliation

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1386805794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MSM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-2400",
            "fax_number": "775-982-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NV",
            "license": "17429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201226460",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114032200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "JACK",
            "middle_name": "ELLEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Sullivan, PHARMD
• David E. Sullivan, M.D.
• Donel Sullivan, PHARM D.
• Gabrielle Sullivan
• James E Sullivan III, D.O.
• Lindsy Sullivan, LSW
• Megan Michele Sullivan, LMSW, CSW-INTERN
• Nickolas Allan Sullivan, HIS
• Sara Margaret Sullivan, PA-C
• Shannon Rose Sullivan, MS, CF-SLP

• Cardiovascular Disease Physician in Reno, NV
• Providers in Reno, NV by specialty
• Cardiovascular Disease Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.