Michael J. Sullivan, M.S., P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA536 Issued in NV

Practice address

112 S Jones Blvd
Las Vegas, NV 89107-2614

Phone

(702) 838-7110

Fax

(702) 838-7112

NPI assigned

Jul 28, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

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.

• A Better Option Healthcare Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Las Vegas, NV
  • NPI 1285155325
  NPD (past)
• Advanced House Calls Inc

  • Specialist
  • Las Vegas, NV
  • NPI 1295732451
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1821098104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072614",
            "telephone_number": "702-838-7110",
            "fax_number": "702-838-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072614",
            "telephone_number": "702-838-7110",
            "fax_number": "702-838-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "M.S., P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sullivan
• Kristin Sullivan
• Leslie A Sullivan, MSW, LSW
• Liam Kelly Sullivan, MD
• Madeline Sullivan, DMD
• Michaela Sullivan
• Michaele Anne Sullivan, NURSE PRACTITIONER
• Sandra Jean Sullivan
• Sara Nivens Sullivan, L.S.W.
• Selah Allegra Sullivan, SLP

• Medical Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Medical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.