Laura Ann Sullivan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301513782 Issued in MI

Practice address

5500 Auto Club Dr
Dearborn, MI 48126-2779

Phone

(313) 425-4705

NPI assigned

Mar 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsullivan1086673@direct.hfhs.org

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.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Henry Ford Health System

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1003990318
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1801391313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-876-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 AUTO CLUB DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262779",
            "telephone_number": "313-425-4705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Deeds Park Dr",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454042699",
            "country_code": "US",
            "telephone_number": "937-800-1235",
            "fax_number": "937-800-1237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Acorn Dr",
            "address_purpose": "LOCATION",
            "city": "Oakwood",
            "state": "OH",
            "postal_code": "454193509",
            "country_code": "US",
            "telephone_number": "614-370-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.143333",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301513782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0292514",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amirah Suggs
• Kevin M Suiter, MD
• Jiab Suleiman, DO
• Dominique Sulla
• Jaymie Elizabeth Sullins
• Tara Roberta Sullivan, RN,IBCLC,LCCE
• Zillay Huma Sultan, PA-C
• Onita Marshea Sumler
• Amanda Lee Summerfield, NP
• Summit Home Care, LLC

• Pediatrics Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.