Sullivan Doumont, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110005994 Issued in VA

Practice address

1830 Plaza Dr
Winchester, VA 22601-6365

Phone

(540) 665-8414

NPI assigned

Feb 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Sullivan Parkes Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Matthews-Vu Medical Group, P.C.

  • Internal Medicine Physician
  • Colorado Springs, CO
  • NPI 1649438433
  NPD
• Shenandoah University

  • Orthopaedic Surgery Physician
  • Winchester, VA
  • NPI 1689231912
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Oca MWC LP

  • Family Medicine Physician
  • Midwest City, OK
  • NPI 1417105321
  NPD (past)

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1992163224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 HITES RD",
            "city": "MIDDLETOWN",
            "state": "VA",
            "postal_code": "226452002",
            "telephone_number": "540-539-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-665-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUMONT",
        "first_name": "SULLIVAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0006194",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2647",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SULLIVAN",
            "last_name": "PARKES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark William Doering, MD
• Jamie Lee Doherty, LPN
• Madison Marilee Dolly
• Amanda Grace Dondero, LCSW
• Kassie Donovan, PA-C
• Bailey Dove
• Kali Ann Dove, PMHNP/APRN
• Steven Martin Dowdy
• Jonathan A Doyle, LCSW
• Margaret Doyle

• Physician Assistant in Winchester, VA
• Providers in Winchester, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.