THERESA E SULLIVAN (NPI# 1447539655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447539655 |
| Entity Type | Individual |
| Full Name | THERESA E SULLIVAN |
| Credential | D.O. , M.P.H |
| Practice Address |
975 Port Washington Rd Grafton WI 53024 |
| Mailing Address |
3301 W Forest Home Ave Milwaukee WI 53215-2843 |
| Practice Telephone | 2623291000 |
| Practice Fax Number | 2623291001 |
| Mailing Telephone | 4143892338 |
| Mailing Fax Number | 4143858987 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 62926 | WI | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 125060039 | IL | Allopathic & Osteopathic Physicians |
| Y | 208M00000X | Hospitalist | 62926 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | STATE LICENSE | 032.0109679 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992339121 | Theresa Sullivan | Social Worker | 910 S Chapel St Ste 102, Newark, DE 19713-3468 | 2020-02-26 |
| 1003365222 | Theresa Sullivan | Counselor | 17720 Ne Halsey St Ste B, Portland, OR 97230-6771 | 2016-09-29 |
| 1255500039 | Theresa Sullivan | Speech-Language Pathologist | 315 E Dunklin St, Jefferson City, MO 65101-3128 | 2008-02-26 |
| 1184826521 | Theresa Marie Sullivan | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-06-05 |
| 1205055076 | Theresa Paulette Sullivan | Audiologist | 250 Tuytenbridge Rd, Lake Katrine, NY 12449-5429 | 2007-04-24 |
| 1063599009 | Theresa M. Sullivan | Clinical Nurse Specialist | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2006-11-01 |
| 1194734491 | Theresa K Sullivan | Physical Therapist | 7900 E Green Lake Dr N, Suite 204, Seattle, WA 98103-4800 | 2006-08-05 |
| Street Address |
975 PORT WASHINGTON RD |
| City | GRAFTON |
| State | WI |
| Zip Code | 53024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292610 | Robert N. Fish | Anesthesiology | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2005-08-18 |
| 1700499845 | Melissa A Stock | Nurse Practitioner | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-08-28 |
| 1689292708 | Scott Thompson | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-07-07 |
| 1740807296 | Todd R Stanley | Registered Nurse | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-07-01 |
| 1639792666 | Emily Ann Feather | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-05-26 |
| 1073136180 | Jasleen Guru | Physical Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-05-22 |
| 1811517097 | William Knox | Occupational Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-04-17 |
| 1679192314 | Caitlin Marie Hill | Speech-Language Pathologist | 975 Port Washington Rd, Grafton, WI 53024-9204 | 2020-04-13 |
| 1447888789 | Beverly Altman | Massage Therapist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-03-31 |
| 1013540566 | Matthew David Poli | Physician Assistant | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2020-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739135 | Kathy Anne Herzog | Counselor | 101 Falls Rd Suite 210, Grafton, WI 53024 | 2018-02-06 |
| 1992215867 | Caroline Marie Brandt | Nurse Practitioner | 975 Port Washington Rd Ste 310, Grafton, WI 53024 | 2017-10-05 |
| 1124569181 | Quirt Family Dentistry, Sc | Dentist | 1580 Port Washington Road, Grafton, WI 53024 | 2017-03-10 |
| 1639626260 | Jennifer Pogodzinski | Physical Therapist | 975 N. Port Washington Avenue, Grafton, WI 53024 | 2016-09-01 |
| 1750790119 | Amanda K Olejniczak | Dentist | 1505 Wisconsin Ave, Ste 130, Grafton, WI 53024 | 2014-08-10 |
| 1992053680 | Liliya Lakshtanov | Registered Nurse | 910 E. Paradise Dr., West Bend, WI 53024 | 2012-08-28 |
| 1467708446 | Trevor Holwell | Pharmacist | 1600 N Port Washington Rd, Grafton, WI 53024 | 2012-07-27 |
| 1770838120 | Brian A. Vetterkind | Physical Therapist | 2225 Wisconsin Ave Ste 100, Grafton, WI 53024 | 2012-07-20 |
| 1366774689 | Tracy Lynn Doro-krueger | Counselor | 1814 Arapaho Court, Grafton, WI 53024 | 2010-02-11 |
| 1659507754 | Karen Marie Geschke | Physical Therapist | 2020 Cheyenne Ct., Grafton, WI 53024 | 2009-06-03 |
| Find all providers in zip 53024 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275774192 | Ran Guan | Hospitalist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2009-03-23 |
| 1023207586 | Syed Taimur Ali | Hospitalist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2007-10-22 |
| 1205984945 | Farah Hamdard | Hospitalist | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477896355 | James David Alstott | Hospitalist | 444 W Wilson St Apt 309, Madison, WI 53703-4024 | 2013-03-29 |
| 1871864629 | Malini Guha Majumder | Hospitalist | 2900 W Oaklahoma Ave, Suite 315, Milwaukee, WI 53215 | 2012-01-25 |
| 1255656013 | Hannah Irene Bell | Hospitalist | 1106 Wellesley Rd, Madison, WI 53705 | 2010-04-05 |
| 1639309453 | Eugene Enriquez | Hospitalist | 5665 Golden Rain Ct, New Berlin, WI 53151-8733 | 2009-07-15 |
| 1073742672 | Sudhir Duvuru | Hospitalist | Marshfield Clinic 1000 N Oak Ave, Marshfield, WI 54449-5777 | 2009-07-06 |
| 1760636070 | Ndidiamaka Cecilia Agu | Hospitalist | 835 S. Van Buren St., Green Bay, WI 54301-3526 | 2008-11-13 |
| 1285852889 | Brian Thomas Jubeck | Hospitalist | 1008 Beloit Ct, Madison, WI 53705-2233 | 2007-04-22 |
| 1265458053 | Suzanne Victoria Powell | Hospitalist | 141 Siegler St, Dept of Veterans Affairs, Green Bay, WI 54303-2635 | 2006-07-14 |
| 1023055910 | Margaret M Pearsall | Hospitalist | Beloit Memorial Hospital, 1969 W. Hart Road, Beloit, WI 53511-2230 | 2006-06-01 |
| 1205809936 | Allen W. Chu | Hospitalist | 725 American Ave Rm 2036, Prohealth Care Hospitalists Program, Waukesha, WI 53188-5031 | 2006-02-13 |
| Find all providers with the same taxonomy | ||||
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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.