Vincent E. Sullivan, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18213 Issued in IA

Practice address

19878 Saint Joseph Dr
Centerville, IA 52544-8850

Phone

(641) 437-1576

Fax

(641) 437-4205

NPI assigned

Jan 20, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Vincent E. Sullivan MD PC

  • Surgery Physician
  • Centerville, IA
  • NPI 1174705628
  NPD Authorized official
• Boone County Hospital

  • Critical Access Hospital
  • Boone, IA
  • NPI 1467434225
  NPD (past)
• Mercy Medical Center-Centerville

  • Nursing Facility/Intermediate Care Facility
  • Centerville, IA
  • NPI 1265482541
  NPD (past)
• Mercy Medical Center-Centerville

  • Emergency Care Clinic/Center
  • Centerville, IA
  • NPI 1528018801
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1750361036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19878 SAINT JOSEPH DR",
            "address_2": "POST OFFICE BOX 160",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525448850",
            "telephone_number": "641-437-1576",
            "fax_number": "641-437-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19878 SAINT JOSEPH DR",
            "city": "CENTERVILLE",
            "state": "IA",
            "postal_code": "525448850",
            "telephone_number": "641-437-1576",
            "fax_number": "641-437-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "VINCENT",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "18213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0186270",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• State University of Iowa
• Stater Dental
• Lauren Nicole Stayner
• Colleen Elizabeth Stephens, LISW BCO
• Cassidy Stewart
• The Continental at St. Joseph'S
• Brianne Elyse Thompson, M.A., CCC-SLP
• Jennifer Tomlin, ARNP
• Total Dose Centerville, LLC
• Total Dose Centerville, LLC

• Surgery Physician in Centerville, IA
• Providers in Centerville, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.