Evelyn R Sullivan, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0005750 Issued in FL

Practice address

2653 SW 87TH Dr
Suite a
Gainesville, FL 32608-9313

Phone

(352) 331-0020

Fax

(352) 331-0022

NPI assigned

Sep 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1871697110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 SW 87TH DR",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089313",
            "telephone_number": "352-331-0020",
            "fax_number": "352-331-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 SW 87TH DR",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089313",
            "telephone_number": "352-331-0020",
            "fax_number": "352-331-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "EVELYN",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY0005750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "54357",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tameika Suggs
• Insherah Sughayer, MD, LMHC
• Mohamad Anas Sukkari
• Cheri A Sulek, MD
• Caitlin Tara Sullivan, D.O.
• Kathleen Sullivan
• Kayla Sullivan
• Kevin J. Sullivan, MD
• Margaret Burns Sullivan, LCSW
• Matthew Daniel Sullivan, DMD

• Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.