THEODORE K. SULLIVAN (NPI# 1437153772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437153772 |
| Entity Type | Individual |
| Full Name | THEODORE K. SULLIVAN |
| Credential | O.D. |
| Practice Address |
3071 Phoenix Center Dr Washington MO 63090-5690 |
| Mailing Address |
15933 Clayton Rd Ste 201 Ballwin MO 63011-2172 |
| Practice Telephone | 6367772345 |
| Practice Fax Number | 6367772115 |
| Mailing Telephone | 6362004393 |
| Mailing Fax Number | 6365270766 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2017-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | T02915 | MO | Eye and Vision Services Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 121 Hunter Ave, Ste 102, Clayton, MO 631242000 | 3147211140 | 3147211863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144216938 | Theodore Robert Sullivan | Surgery | 1245 Highland Ave, Suite 600, Abington, PA 19001-3714 | 2005-09-27 |
| Street Address |
3071 PHOENIX CENTER DR |
| City | WASHINGTON |
| State | MO |
| Zip Code | 63090-5690 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851520175 | Kevin Michael Biermann | Optometrist | 3071 Phoenix Center Dr, Washington, MO 63090-5690 | 2009-07-08 |
| 1336145481 | Amanda Jessie Bissell | Optometrist | 3071 Phoenix Center Dr, Washington, MO 63090-5690 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798792 | Alicia Caroline Baker | Nurse Practitioner | 1070 W 7th St, Washington, MO 63090 | 2020-10-21 |
| 1962975839 | Jennifer Biermann | Pharmacist | 801 E 5th Street, Washington, MO 63090 | 2019-01-03 |
| 1487199733 | Kristen Elaine Cleavelin | Registered Nurse | Mercy Convenient Care, 901 Patients First Drive, Washington, MO 63090 | 2016-12-22 |
| 1699146712 | Washington Community Counseling Center | Community/Behavioral Health | 421 W. 5th Street, Suite 110, Washington, MO 63090 | 2015-10-15 |
| 1598002024 | Americare At Vicotrian Manor of Washington, LLC | Assisted Living Facility | 2701 Rabbit Trail Dr, Washington, MO 63090 | 2013-01-03 |
| 1578824116 | Rhonda Ann Pepmiller | Nurse Practitioner | 851 E 5th St Ste 309, Washington, MO 63090 | 2012-05-30 |
| 1932486032 | Julie Joanne Lynch | Pharmacist | 890 Country Corners, Washington, MO 63090 | 2011-11-03 |
| 1043590839 | Laurie Elizabeth Bryson | Counselor | 102 Elm Street, Suite 204, Washington, MO 63090 | 2011-08-24 |
| 1164737490 | Mohan Mallikarjuna Edupuganti | Internal Medicine | 901 Patients First Dr Ste 2500, Washington, MO 63090 | 2010-08-11 |
| 1154640225 | Nicholas W Frederickson | Internal Medicine | 901 Patients First Drive Suite 3300, Washington, MO 63090 | 2010-05-27 |
| Find all providers in zip 63090 | ||||
| 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 |
|---|---|---|---|---|
| 1457997231 | Erik Johnson-saint Paine | Optometrist | 1924 8th St Nw Ste 105, Washington, DC 20001-3457 | 2019-11-27 |
| 1518512078 | Tahira Raja | Optometrist | 1602 L St Nw Ste 400, Washington, DC 20036-5691 | 2019-08-01 |
| 1942799234 | Jenna O'brien O.d. Pllc | Optometrist | 1038 S White Sands Dr, Washington, UT 84780-8202 | 2018-05-02 |
| 1609394931 | Onevision, Inc. | Optometrist | 3620 South Dakota Ave Ne, Washington, DC 20018 | 2017-09-07 |
| 1366963092 | Evelyn Dearing | Optometrist | 3418 Wisconsin Avenue Nw, Washington, DC 20016 | 2017-07-03 |
| 1477083772 | Alexander David Mcclure | Optometrist | 851 E 5th St Ste 112, Washington, MO 63090-3128 | 2017-06-19 |
| 1629504535 | Onyekachukwu Illoh | Optometrist | 1924 8th St Nw, Washington, DC 20001-3286 | 2017-05-11 |
| 1821459082 | Myeyedr Optometry of Dc, LLC | Optometrist | 3418 Wisconsin Ave Nw, Washington, DC 20016 | 2016-03-16 |
| 1942674197 | Jennifer D Luckie | Optometrist | 1016 16th St Nw Bsmt Ll, Washington, DC 20036-5729 | 2015-11-25 |
| 1891170494 | Keith Versteegden | Optometrist | 3620 S Dakota Ave Ne, Washington, DC 20018-3026 | 2015-07-23 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 63090 |
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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.