Ernest Eugene Sullivent III, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

J8386 Issued in TX

Practice address

8034 Edgerton Drive
Suite 132
Usaf Academy, CO 80840-2200

Phone

(719) 333-7716

Fax

(719) 333-3578

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1447288188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8034 EDGERTON DRIVE",
            "address_2": "SUITE 132",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402200",
            "telephone_number": "719-333-7716",
            "fax_number": "719-333-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8034 EDGERTON DRIVE",
            "address_2": "SUITE 132",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402200",
            "telephone_number": "719-333-7716",
            "fax_number": "719-333-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVENT",
        "first_name": "ERNEST",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "J8386",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J8386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131177107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirk Bradley Stetson, D.D.S.
• Deborah L Stevens-Conrad, PHARMD
• Kendra Terry Stilwell, D.O.
• Timothy William Stilwell, PA-C
• Jennie-Leigh L Stoddart, DDS
• Dawn Michele Szarke, CPNP-BC
• Dawn A Tanner, LICSW
• Casey Taylor, DO
• Michael Thompson, PA
• Timothy Paul Tinius, PHD

• Emergency Medicine Physician in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.