Kelly Ann Sullivan, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0102202783 Issued in VA

Practice address

7447 Central Business Park Dr Ste 1400
Norfolk, VA 23513-2831

Phone

(757) 756-5600

Fax

(757) 904-1602

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of NorfolkGroup PAC ID 8325001951, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• City of Norfolk

  • Psychiatry Physician
  • Norfolk, VA
  • NPI 1306800198
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1407056815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 CENTRAL BUSINESS PARK DR STE 1400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235132831",
            "telephone_number": "757-756-5600",
            "fax_number": "757-904-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 CENTRAL BUSINESS PARK DR STE 1400",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235132831",
            "telephone_number": "757-756-5600",
            "fax_number": "757-904-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102202783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayman Suliman
• Amber Sullivan, DO
• Brianne Jane Sullivan
• Corie Sullivan, OT
• Deborah Sheryl Sullivan
• Molly Sullivan, PT, DPT
• Neil Michael Sullivan, M.D.
• Nadia Sultan
• Chrisna Cole Summers, COTA/L
• Matthew Raymond Summers, M.D.

• Psychiatry Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.