Ryan Sullivan, D.O.
Individual provider Active NPI Emergency Medicine Physician · Fort Smith, AR
NPI 1801029657 · NPPES record last updated Dec 2, 2022
Key facts
- NPI
- 1801029657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- E-8248 (AR)
- Practice address
- 7301 Rogers Ave
Fort Smith, AR 72903-4100 - Phone
- (479) 314-6241
- Fax
- (479) 452-0275
- NPI assigned
- Aug 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Pacific University - College of Optometry, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Greenbrier Emergency Services, Inc.
Southeastern Emergency Physicians LLC
Hospital Care Consultants Inc
Practice addresses (Care Compare)
1555 Exchange Ave
Baptist Health Medical Center Conway
Conway, AR 72032-7824
Phone (501) 585-2000
211 Crawford Memorial Dr
Van Buren, AR 72956-5322
Phone (479) 474-3401
213 E Redwood Ave
Sallisaw, OK 74955-2811
Phone (918) 774-1100
Hospital & facility affiliations
- Baptist Health - Fort Smith
- Sequoyah County-City of Sallisaw Hospital Authorit
- Mercy Hospital Fort Smith
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OK, AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091007000369 | OK | Practitioner - Emergency Medicine | 4688710502 | Reassigns benefits to 5 organizations |
| I20140401000920 | AR | Practitioner - Emergency Medicine | 4688710502 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-8248 | AR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Medcare, Inc | Emergency Medicine | Current |
Accepting new patients |
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients | |
| Mercy Clinic Fort Smith Communities | Current |
Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current |
Accepting new patients | |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
| Greenbrier Emergency Services, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Hospital Care Consultants, Inc | Emergency Medicine | Current |
Accepting new patients |
| Mercy Clinic Oklahoma Communities | Current |
Accepting new patients | |
| Mercy Clinic Fort Smith Communities | Current |
Accepting new patients | |
| Baptist Health Regional Hospitals | Past | Accepting new patients | |
| Sequoyah County City of Sallisaw Hospital Authority | Past | Accepting new patients |
Locations
3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
1555 Exchange Ave
Conway, AR 72032
Phone (501) 202-2300
1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980
7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600
7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215
3333 Springhill Dr
North Little Rock, AR 72117
Phone (501) 202-3000
2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000
211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300
430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251
1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658
4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455
213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100
905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | E-8248 | AR | Yes |
| Emergency Medicine Physician | 207P00000X | 4817 | OK |
Addresses
Primary practice location
7301 Rogers Ave
Fort Smith, AR 72903-4100
Mailing address
7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6241
Other practice location 1
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7709
Other practice location 2
2710 S Rife Medical Ln
Rogers, AR 72758-1452
Phone (479) 636-0200
Other providers in Fort Smith, AR
- Billie Sudigala
- Shreya Sukralia
- Brittany N Sullivan
- Chasity Renae Sullivan
- Eric Scott Sullivan
- Mari Sumbler
- Balasasikumar Sundaram
- Vikki L Sutterfield
- Jennifer L Sutton
- Katlyn Sutton
All providers in Fort Smith, AR · Emergency Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.