MR. SCOTT PATRIC SULLIVAN (NPI# 1033496179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033496179 |
| Entity Type | Individual |
| Full Name | MR. SCOTT PATRIC SULLIVAN |
| Credential | M.H.A.,A.T.C, R.K.T. |
| Practice Address |
205 S Main St Suite C Longmont CO 80501-1716 |
| Mailing Address |
1520 Red Mountain Dr Longmont CO 80504-2277 |
| Practice Telephone | 3036849525 |
| Practice Fax Number | 3037747899 |
| Mailing Telephone | 3036849525 |
| Mailing Fax Number | 3037747899 |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
609 | CO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950737 | Scott Jeffrey Sullivan | Dentist | 3516 S 47th St Ste 104, Tacoma, WA 98409-4427 | 2017-09-06 |
| 1477070522 | Scott Sullivan | Physical Therapist | 5320 Mark Dabling Blvd # 100, Colorado Springs, CO 80918-3839 | 2017-08-29 |
| 1063612844 | Scott Louis Sullivan | Dentist | 76 Doctors Park Dr., Santa Rosa, CA 95405-6615 | 2007-07-20 |
| 1154344000 | Scott Keith Sullivan Jr. | Surgery | 1717 Saint Charles Ave, New Orleans, LA 70130-5223 | 2006-07-25 |
| 1972134567 | Scott R Sullivan | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd, Dallas, TX 75235-7709 | 2020-02-01 |
| 1770056608 | Scott Lamar Sullivan | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2019-01-03 |
| 1386143899 | Scott Sullivan | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2018-02-10 |
| 1689100471 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 2390 W Congress St, Lafayette, LA 70506-4205 | 2017-05-11 |
| 1932467123 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2012-04-25 |
| 1750440004 | Scott G Sullivan | Physician Assistant | 301 Andrews Avenue, (lyster Army Health Clinic), Fort Rucker, AL 36362-5000 | 2006-12-06 |
| Street Address |
205 S MAIN ST SUITE C |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-1716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023000692 | John Christopher Fueston | Dermatology | 205 S Main St, Suite E, Longmont, CO 80501-1716 | 2005-08-18 |
| 1467993006 | Sun Lee | Physical Therapy Assistant | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2017-03-15 |
| 1003274192 | Colin Strack | Physician Assistant | 205 S Main St, Suite A, Longmont, CO 80501-1716 | 2016-02-03 |
| 1144593872 | Nathaniel Foster | Physical Therapy Assistant | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2012-02-10 |
| 1881961316 | Front Range Eye Physicians PC | Ophthalmology | 205 S Main St, Suite D, Longmont, CO 80501-1716 | 2011-11-29 |
| 1003137134 | Workwell Occupational Medicine | Clinic/Center | 205 S Main St, Longmont, CO 80501-1716 | 2010-06-11 |
| 1376775023 | House Call Physicians, PC | Family Medicine | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2009-08-13 |
| 1760647333 | Evan Matthew Little | Physical Therapist | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2008-07-23 |
| 1467628404 | Twin Peaks Dermatology, PC | Dermatology | 205 S Main St, Suite E, Longmont, CO 80501-1716 | 2008-04-30 |
| 1659404952 | William Ford | Nurse Practitioner | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2007-03-14 |
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|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365930 | Emmalee Zian | Specialist/Technologist | 1565 Cambridge Dr, Longmont, CO 80503-2330 | 2020-01-22 |
| 1609340637 | Destiny Rae Lalaguna | Specialist/Technologist | 234 Harvest St, Longmont, CO 80501-9768 | 2019-01-12 |
| 1972013886 | Karina Marie Doyle | Specialist/Technologist | 36 Baylor Dr, Longmont, CO 80503-2111 | 2017-10-05 |
| 1629465489 | Shea Rasmussen | Specialist/Technologist | 1100 Spencer St, Longmont, CO 80501-3122 | 2015-04-20 |
| 1861880676 | Richard Foster | Specialist/Technologist | 757 County Road 18, Longmont, CO 80504-9482 | 2014-12-31 |
| 1821540360 | Kathleen Retzke | Specialist/Technologist | 1551 Professional Ln, Suite 200, Longmont, CO 80501-6972 | 2016-11-01 |
| 1548663768 | Kiley Stavnes | Specialist/Technologist | 1551 Professional Ln, Suite 200, Longmont, CO 80501-6972 | 2014-10-01 |
| 1558570440 | Lisa G Lear | Specialist/Technologist | 1551 Professional Ln, Suite 200, Longmont, CO 80501-6972 | 2007-05-21 |
| 1205053592 | Kevin Mayeda | Specialist/Technologist | 1551 Professional Ln, Suite # 200, Longmont, CO 80501-6972 | 2007-04-19 |
| 1083839872 | Craig Marshall Krager | Specialist/Technologist | 1551 Professional Ln Unit 200, Longmont, CO 80501-6964 | 2007-04-16 |
| Find all providers in LONGMONT | ||||
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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.