MONICA K SULLIVAN (NPI# 1023257086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023257086 |
| Entity Type | Individual |
| Full Name | MONICA K SULLIVAN |
| Credential | MD |
| Practice Address |
2156 Chamber Center Dr Lakeside Park KY 41017-1669 |
| Mailing Address |
2156 Chamber Center Drive Lake Side Park KY 41017-5446 |
| Practice Telephone | 8593416255 |
| Practice Fax Number | 8595471197 |
| Mailing Telephone | 8593416255 |
| Mailing Fax Number | 8595471197 |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 43346 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100163510 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 413 S Loop Rd, Edgewood, KY 410175446 | 8593013800 | 8593013987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657430 | Monica Sullivan | Physician Assistant | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2018-08-02 |
| 1780108720 | Monica Marie Sullivan | Counselor | 6918 W Windsor Ave, Berwyn, IL 60402-3334 | 2017-08-01 |
| 1073885323 | Monica A. Sullivan | Physician Assistant | 14421 Dupont Ct, Omaha, NE 68144-2100 | 2012-02-02 |
| 1346536364 | Monica Jean Sullivan | Nurse Practitioner | 41 Mall Rd, Lahey Clinic, Burlington, MA 01805-0001 | 2011-06-28 |
| 1881800720 | Monica Marie Sullivan | Occupational Therapist | 23271 Verdugo Dr, #b, Laguna Hills, CA 92653-1347 | 2007-05-15 |
| Street Address |
2156 CHAMBER CENTER DR |
| City | LAKESIDE PARK |
| State | KY |
| Zip Code | 41017-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538159751 | Robert L Wyenandt Jr,md Pllc | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2005-10-27 |
| 1033542170 | Laurie A. Wallace | Nurse Practitioner | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2013-08-13 |
| 1952614935 | Jennifer N Meyers | Nurse Practitioner | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2010-07-20 |
| 1972820280 | Kyle J Legrand | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2010-04-26 |
| 1942238019 | Elizabeth Tanner | Nurse Practitioner | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2006-06-29 |
| 1538146014 | Maria Burton | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538159751 | Robert L Wyenandt Jr,md Pllc | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2005-10-27 |
| 1972820280 | Kyle J Legrand | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2010-04-26 |
| 1154367480 | Ellen Christine Schwartz | Family Medicine | 2300 Chamber Center Dr, Suite 100, Lakeside Park, KY 41017-1673 | 2006-06-22 |
| 1538146014 | Maria Burton | Family Medicine | 2156 Chamber Center Dr, Lakeside Park, KY 41017-1669 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890431 | Alishia Gayle Euler | Family Medicine | 730 Della Dr, Lexington, KY 40504-3610 | 2020-11-01 |
| 1306443908 | Complete Wellness Inc | Family Medicine | 25 Joshua Lane, Hawesville, KY 42348 | 2020-10-06 |
| 1811503410 | Angela Coffman | Family Medicine | 1000 Thompson Dr, Beaver Dam, KY 42320-9152 | 2020-09-18 |
| 1871107375 | West Towne Clinical Services Pllc | Family Medicine | 2755 W Park Dr Ste 1, Paducah, KY 42001-9058 | 2020-09-02 |
| 1528670981 | Visium Healthlink LLC | Family Medicine | 507 Avawam Dr, Richmond, KY 40475-9195 | 2020-08-18 |
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1952929689 | Yasir LLC | Family Medicine | 103 Financial Pl Ste 300, Elizabethtown, KY 42701-4470 | 2020-07-09 |
| 1578188637 | Megan Elizabeth Burke | Family Medicine | 641 Zag Rd, West Liberty, KY 41472-7625 | 2020-06-14 |
| 1679197529 | Kentucky Mountain Interventional and Infusion Therapies, LLC. | Family Medicine | 101 Hibbard St Ste 200, Pikeville, KY 41501-1788 | 2020-06-05 |
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | LAKESIDE PARK |
| Zip Code | 41017 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.