Jan Retherford Sullivan, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

C-5306 Issued in AR

Practice address

4301 W Markham St
Little Rock, AR 72205-7101

Phone

(501) 686-7000

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1780709816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 BOWMAN RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102339",
            "telephone_number": "501-224-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAN",
        "middle_name": "RETHERFORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AR",
            "license": "C5306",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AR",
            "license": "C-5306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Henry Sullivan, M.D.
• Elizabeth Ann Sullivan, M. D.
• Elizabeth Carey Sullivan, MD
• Ellen Sullivan, APN
• Ellen Dawn Sullivan
• Joseph David Sullivan, L.P.C.
• Laura Sullivan, BT
• Lenae Sullivan, MCD, CCC-SLP
• Nicole Sullivan, MD
• Tameka Lashawn Sullivan

• Neurology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Neurology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.