DR. TIMOTHY JAMES SULLIVAN JR. (NPI# 1417956400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417956400 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY JAMES SULLIVAN JR. |
| Credential | M.D. |
| Practice Address |
2300 Pavilion Dr Kingsport TN 37660-4622 |
| Mailing Address |
1021 W Oakland Ave Suite 207 Johnson City TN 37604-2191 |
| Practice Telephone | 4235875571 |
| Practice Fax Number | 4235875237 |
| Mailing Telephone | 4239153104 |
| Mailing Fax Number | 4239523109 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2009-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD18502 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3882277 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024792 | Timothy Sullivan | Specialist/Technologist | 601 E Elm St Apt 1203, Troy, AL 36081-3498 | 2020-08-24 |
| 1215585112 | Timothy Sullivan II | Massage Therapist | 318 E Maiden St, Washington, PA 15301-5108 | 2019-09-04 |
| 1972954675 | Timothy Sullivan | Technician/Technologist | 38 Thatcher St, Rumford, RI 02916-2714 | 2016-06-24 |
| 1982019840 | Timothy Paul Sullivan | Chiropractor | 17000 E Us Highway 40 Ste 7, Independence, MO 64055-5394 | 2014-06-30 |
| 1306110176 | Timothy Coleman Sullivan | Behavioral Analyst | 7291 Garden Grove Blvd, Suite F, Garden Grove, CA 92841-4211 | 2012-02-26 |
| 1235452343 | Timothy Sullivan | Pharmacist | 336 Route 202, Somers, NY 10589-3220 | 2010-03-03 |
| 1619152915 | Timothy Mark Sullivan | Physician Assistant | 9951 E El Moro Ave, Mesa, AZ 85208-5869 | 2008-01-04 |
| 1396819215 | Timothy P Sullivan | Dentist | 370 W Terra Cotta Ave, Crystal Lake, IL 60014-3512 | 2006-11-20 |
| 1154408011 | Timothy Patrick Sullivan | Otolaryngology | 19 N Rivers Edge Dr, Little Silver, NJ 07739-1710 | 2006-10-31 |
| 1881786226 | Timothy Joseph Sullivan | Pediatrics | 92 New London Tpke, Norwich, CT 06360 | 2006-09-29 |
| Street Address |
2300 PAVILION DR |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902438849 | Tonya Jean Keen | Occupational Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2020-02-09 |
| 1669034682 | Victoria Gillenwater | Physical Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2019-06-29 |
| 1649833880 | Brandon Drew Seale | Physical Therapist | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2019-04-14 |
| 1770067415 | April Kuntz | Speech-Language Pathologist | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2018-09-19 |
| 1346739174 | Carson Leigh Ann Johnson | Occupational Therapist | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2018-05-07 |
| 1639670987 | Matthew David Donaldson | Occupational Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2018-02-22 |
| 1437661089 | Brooke Ashley Parton | Physical Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2017-11-03 |
| 1104350685 | Virginia Conkin | Physical Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2017-04-12 |
| 1427590322 | Kelsey Stout | Occupational Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2016-11-08 |
| 1902358724 | Jason Johnson | Physical Therapy Assistant | 2300 Pavilion Dr, Kingsport, TN 37660-4622 | 2016-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750485322 | Psychiatric Associates of Kingsport LLP | Psychiatry & Neurology | 444 Clinchfield St Ste 101, Kingsport, TN 37660-3859 | 2006-09-12 |
| 1609984178 | Eric David Moffet | Psychiatry & Neurology | 1920 Brookside Dr, Suite 15, Kingsport, TN 37660 | 2006-08-26 |
| 1609891563 | Ittamveetil Narayanan Kutty | Psychiatry & Neurology | 2463 Wildwood Dr, Ste 12, Kingsport, TN 37660-5800 | 2006-07-13 |
| 1962432633 | Paul Charles Villeneuve | Psychiatry & Neurology | 2001 Stonebrook Pl, Kingsport, TN 37660-4000 | 2006-07-05 |
| 1770521676 | Sachdev Somiah | Psychiatry & Neurology | 1401 Bridgewater Ln, Kingsport, TN 37660 | 2006-06-03 |
| 1861458978 | Michael R Martin | Psychiatry & Neurology | 1944 Brookside Dr, Suite 1, Kingsport, TN 37660-4618 | 2006-04-26 |
| 1568929818 | Kingsport Psychiatric Services | Psychiatry & Neurology | 1401 Bridgewater Ln, Kingsport, TN 37660-4164 | 2019-02-22 |
| 1649363425 | Ronald Steven Smith | Psychiatry & Neurology | 1920 Brookside Dr, Ste 12, Kingsport, TN 37660-4613 | 2006-10-02 |
| 1659476992 | Blue Ridge Medical Management Corporation | Psychiatry & Neurology | 2000 Brookside Dr, 7th Floor Geriatric Psychic Unit, Kingsport, TN 37660-4627 | 2006-09-13 |
| 1013011790 | Junesik Nuri Yong | Psychiatry & Neurology | 1570 Waverly Road, Kingsport, TN 37664 | 2006-09-12 |
| Find all providers in KINGSPORT | ||||
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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.