Nicole Sullivan, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD.70087066 Issued in WA

Practice address

4301 W Markham St # 837
Little Rock, AR 72205-7101

Phone

(501) 526-6020

NPI assigned

Mar 31, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Diagnostic Radiology

Education

University of Arkansas College of Medicine, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1750919122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ALPINE CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 837",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-526-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 Sheridan St",
            "address_purpose": "LOCATION",
            "city": "Port Townsend",
            "state": "WA",
            "postal_code": "983682443",
            "country_code": "US",
            "telephone_number": "360-385-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD.70087066",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD.70087066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsullivan@uams.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "4301 W Markham St # 837",
            "city": "Little Rock",
            "state": "AR",
            "country_code": "US",
            "postal_code": "722057101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellen Dawn Sullivan
• Jan Retherford Sullivan, M.D.
• Joseph David Sullivan, L.P.C.
• Laura Sullivan, BT
• Lenae Sullivan, MCD, CCC-SLP
• Tameka Lashawn Sullivan
• Abir Sultan Al Tamimi
• Sania Sultana, MD
• Fnu Sumaiya Sharif, MD
• Tara Dyan Summerford, MS CCC SLP

• Diagnostic Radiology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Diagnostic Radiology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.