DR. MICHAEL J SULLIVAN (NPI# 1558486746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558486746 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J SULLIVAN |
| Credential | MD |
| Practice Address |
2510 Bert Kouns Industrial Loop Shreveport LA 71118-3119 |
| Mailing Address |
Po Box 8608 Metairie LA 70011-8608 |
| Practice Telephone | 5048342062 |
| Mailing Telephone | 5048342062 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 017603 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1967432 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918617 | Michael David Sullivan | Social Worker | 403 1/2 Hector St, Ithaca, NY 14850-2025 | 2018-10-15 |
| 1376923292 | Michael Sullivan | Student in an Organized Health Care Education/Training Program | Walter Reed 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2015-06-05 |
| 1881074896 | Michael Gregory Sullivan | Intermediate Care Facility, Mentally Retarded | 30 Hobomack Rd, Quincy, MA 02169-2508 | 2015-06-04 |
| 1104215136 | Michael Sullivan | Perfusionist | 137 Founders Way Ct, Cape Girardeau, MO 63701-9442 | 2015-01-14 |
| 1689927915 | Michael Robert Sullivan | Pharmacist | 41 Buena Vista St, Stamford, CT 06907-2402 | 2012-10-24 |
| 1154672038 | Michael James Sullivan | Dentist | 1882 Hard Rd, Columbus, OH 43235-1996 | 2012-10-02 |
| 1063791747 | Michael Gruer Sullivan | Counselor | 2024 N. Crystal Lake Dr., Suite 200 Room 205, Lakeland, FL 33801-6015 | 2011-08-11 |
| 1457647083 | Michael Patrick Sullivan | Dentist | 1008 G Sreet, Geneva, NE 68361 | 2011-06-22 |
| 1841528585 | Michael Andrew Sullivan | Counselor | 974 73rd St Ste 9, Windsor Heights, IA 50324-1026 | 2009-11-18 |
| 1508191388 | Michael Joseph Sullivan | Audiologist | 6644 Penn Ave S, Richfield, MN 55423-2026 | 2009-10-12 |
| Street Address |
2510 BERT KOUNS INDUSTRIAL LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-3119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003882820 | Billy B Miller IIi | Nurse Anesthetist, Certified Registered | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2006-02-23 |
| 1417367616 | Sarah Hatfield | Nurse Practitioner | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2014-04-28 |
| 1164740262 | Craig Chu | Pediatrics | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2010-05-13 |
| 1629201538 | Sharon Tran | Pediatrics | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2009-08-25 |
| 1295981363 | Wk Behavioral Health Services | Psychiatry & Neurology | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2008-08-08 |
| 1578774881 | Aja Welch Menard | Psychiatry & Neurology | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2007-05-25 |
| 1649309345 | John J Felty | Emergency Medicine | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118 | 2007-03-06 |
| 1124170691 | Willis Knighton Medical Center, Inc. | General Acute Care Hospital | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2007-01-17 |
| 1215094040 | Patrick Timothy Gallagher Sr. | Emergency Medicine | 2510 Bert Kouns Industrial Loop, Shreveport, LA 71118-3119 | 2007-01-02 |
| 1285666487 | Gerald Brent Whitton | Pediatrics | 2510 Bert Kouns Industrial Loop, Room 215, Shreveport, LA 71118-3119 | 2006-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982871182 | Edward Locascio | Emergency Medicine | 1512 W Kirby Place, Department of Emergency Medicine, Shreveport, LA 71103-3822 | 2008-05-15 |
| 1780722686 | Joseph Salvador Bianca | Emergency Medicine | 715 Chinquapin Dr, Shreveport, LA 71106-7200 | 2007-02-02 |
| 1902950363 | Richard A Aycock II | Emergency Medicine | 2510 Bert Kouns Indistrial Loop, Shreveport, LA 71118 | 2007-01-23 |
| 1962555342 | Charles Leonard Black | Emergency Medicine | 7600 General Motors Blvd, Medical Department, Shreveport, LA 71129-9426 | 2007-01-19 |
| 1801820121 | Mary Ann Edens | Emergency Medicine | 1501 King's Highway, Shreveport, LA 71103 | 2006-07-10 |
| 1992738629 | Paul Bracey | Emergency Medicine | 6841 Fern Avenue, Suite 100, Shreveport, LA 71105 | 2006-07-08 |
| 1306875570 | Edward Ronald Samper | Emergency Medicine | 1666 E Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71105-5714 | 2006-07-01 |
| 1366482309 | Kenneth David Miller | Emergency Medicine | 11165 Heritage Oaks, Shreveport, LA 71106-8383 | 2006-06-07 |
| 1225084536 | John Kevin Netterville | Emergency Medicine | One St Mary Place, Shreveport, LA 71101 | 2006-05-26 |
| 1245206077 | Jerel L Raney | Emergency Medicine | 7045 Youree Dr, Shreveport, LA 71105-5108 | 2006-02-23 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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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.