David Lee Sullivan Jr.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

513 Cannons LN
Louisville, KY 40207-3645

Phone

(502) 403-6886

NPI assigned

Jun 20, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1669966966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 CANNONS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073645",
            "telephone_number": "502-403-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 CANNONS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073645",
            "telephone_number": "502-403-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sullivan Psychiatric Group, PLLC
• Sullivan University System
• Sullivan University System Inc
• Amanda Michelle Sullivan, ARNP
• Aubrey Ross Obradovich Sullivan, M. ED
• Elizabeth Sullivan, MA
• Izabella Sullivan, APRN
• Janice Elaine Sullivan, MD
• Jessica Sullivan
• Joeli Rae Sullivan

• Case Manager/Care Coordinator in Louisville, KY
• Providers in Louisville, KY by specialty
• Case Manager/Care Coordinator in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.