Sullivan MD PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

22176 Issued in AZ

Legal business name

SULLIVAN MD PLLC

Practice address

5100 E Hwy 90
Suite B
Sierra Vista, AZ 85635-2443

Phone

(520) 417-9727

Fax

(520) 417-9733

NPI assigned

Mar 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William Robert Sullivan, MDNPI 1154483477

Title

President

Phone

(520) 417-9729

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Sullivan, MD

  • Psychiatry Physician
  • Sierra Vista, AZ
  • NPI 1154483477
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1851531933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 E. HWY. 90",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-417-9727",
            "fax_number": "520-417-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 E HWY 90",
            "address_2": "SUITE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352443",
            "telephone_number": "520-417-9727",
            "fax_number": "520-417-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-417-9729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "22176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lynn Stoll, PA-C
• Alexis Francesca Stonicher
• Angela S Strebe, SLPA
• G. Delaney Sturgeon, MD
• Ericka Jean Sullins
• Tamika Michelle Sullivan, LCSW
• William Sullivan, MD
• Suncloud Chiropractic, PLLC
• Sunrise Behavior Solutions PLLC
• Saumya Surti Mahammad, DO

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.