DR. JENNA LELSEY SULLIVAN (NPI# 1366936932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366936932 |
| Entity Type | Individual |
| Full Name | DR. JENNA LELSEY SULLIVAN |
| Credential | OD |
| Practice Address |
1 Bank Ave Kaukauna WI 54130-2581 |
| Mailing Address |
2331 Willow Drop Way Oviedo FL 32766-7083 |
| Practice Telephone | 9207662481 |
| Mailing Telephone | 7326842761 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 3564-35 | WI | Eye and Vision Services Providers |
| N | 152W00000X | Optometrist | OPC5544 | FL | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| N1739 Lily of The Valley Dr Ste 2, Greenville, WI 549429104 | 9205603937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588106686 | Jenna Lynn Sullivan | Occupational Therapist | 1813 E 33rd St, Brooklyn, NY 11234-4425 | 2016-11-07 |
| 1548558257 | Jenna Sullivan | Physician Assistant | 327 Central Avenue Se, Minneapolis, MN 55414 | 2011-07-14 |
| 1568935088 | Jenna Sullivan | Student in an Organized Health Care Education/Training Program | 187 W Schrock Rd, Westerville, OH 43081-2890 | 2019-01-08 |
| 1871901769 | Jenna Sullivan | Specialist/Technologist | 8322 Bellona Ave, St 100, Towson, MD 21204 | 2014-07-24 |
| 1003223314 | Jenna Sullivan | Nurse Anesthetist, Certified Registered | 7500 Mercy Road, Omaha, NE 68124-2319 | 2014-07-18 |
| Street Address |
1 BANK AVE |
| City | KAUKAUNA |
| State | WI |
| Zip Code | 54130-2581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255389201 | Mark Arthur Ebben | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2006-05-04 |
| 1730602467 | Mary Kathryn Schroeder | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2017-07-25 |
| 1760913362 | Heather A. Reardon LLC | Counselor | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2017-03-24 |
| 1831636828 | Magiera Eyecare LLC. | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2017-01-27 |
| 1154456093 | Magiera Eyecare LLC | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2576 | 2007-02-22 |
| 1831260611 | Orthopedic and Spine Therapy of Menasha Sc | Physical Therapist | 1 Bank Ave, Suite C, Kaukauna, WI 54130-2581 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194194209 | Kasey Trunk | Specialist/Technologist | W892 Hwy 96, Kaukauna, WI 54130 | 2015-09-18 |
| 1811313760 | Ekin Tongze Yang | Non-emergency Medical Transport (VAN) | 230 W. 12th St, Kaukauna, WI 54130 | 2014-03-14 |
| 1386934834 | Nichole L Huss | Counselor | N9663 Bies Rd, Kaukauna, WI 54130 | 2011-04-17 |
| 1659305878 | Aurora Pharmacy Inc | Pharmacy | 1500 Arbor Way, Suite 100, Kaukauna, WI 54130 | 2006-07-11 |
| 1164471504 | Margaret Ann Roberts | Registered Nurse | 513 Desnoyer Street, Kaukauna, WI 54130 | 2006-05-10 |
| 1578529863 | Gregory A Johnson | Family Medicine | 305 East 12th Street, Kaukauna, WI 54130 | 2006-04-25 |
| 1780646117 | Anita M. Ambrosius | Registered Nurse | 120 Washington St, Kaukauna, WI 54130 | 2006-04-03 |
| 1821614710 | Baycare Aurora Kaukauna Surgery Center LLC | Clinic/Center | 1500 Arbor Way, Kaukauna, WI 54130 | 2020-06-17 |
| 1023438579 | Erin Mae Johnson | Physician Assistant | 2601 Fieldcrest Dr, Kaukauna, WI 54130 | 2014-04-23 |
| 1386978260 | Jennifer Lea Baumgart | Nurse Practitioner | 305 E 12th St, Kaukauna, WI 54130 | 2009-09-25 |
| Find all providers in zip 54130 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851344642 | David G Vanderloop II | Optometrist | 1901 Crooks Ave Ste C, Kaukauna, WI 54130-3200 | 2006-05-19 |
| 1255389201 | Mark Arthur Ebben | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2006-05-04 |
| 1730602467 | Mary Kathryn Schroeder | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2017-07-25 |
| 1831636828 | Magiera Eyecare LLC. | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2581 | 2017-01-27 |
| 1982088944 | Clear Approach Optometry Sc | Optometrist | 1901 Crooks Ave Ste C, Kaukauna, WI 54130-3200 | 2015-07-18 |
| 1154456093 | Magiera Eyecare LLC | Optometrist | 1 Bank Ave, Kaukauna, WI 54130-2576 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939288 | Myeyedr Optometry of Wisconsin, LLC | Optometrist | 2505 N Mayfair Rd Ste 100, Wauwatosa, WI 53226-1404 | 2020-07-15 |
| 1689291254 | Lynne's Moc, LLC | Optometrist | 512 State Street, Madison, WI 53703 | 2020-06-30 |
| 1891311775 | Elizabeth Carman Somers | Optometrist | 3621 Market Ln, Kenosha, WI 53144-1553 | 2020-06-17 |
| 1760008619 | Melanie Nielsen | Optometrist | S73w16437 Janesville Rd, Muskego, WI 53150-9723 | 2020-06-16 |
| 1487278479 | Alyssa Chrisman | Optometrist | 2910 Roosevelt Rd # D1, Marinette, WI 54143-5108 | 2020-06-04 |
| 1043859341 | Site 4 Eyes | Optometrist | 7245 S 76th St, Franklin, WI 53132-9041 | 2020-01-03 |
| 1932745163 | Mauston Family Eyecare, LLC | Optometrist | 205 Division St Ste A, Mauston, WI 53948-2110 | 2019-11-22 |
| 1114562345 | Dr Christopher D Smith & Associates LLC | Optometrist | 2665 Monroe Rd Ste 100, De Pere, WI 54115-9287 | 2019-11-12 |
| 1013564111 | Ayman Tabani | Optometrist | 9160 76th St Unit C, Kenosha, WI 53158-1945 | 2019-08-22 |
| 1104473537 | Espy Specs Sc | Optometrist | 2720 Golf Rd, Eau Claire, WI 54701-8011 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. JENNA LELSEY SULLIVAN.
| 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.