KEVIN SULLIVAN (NPI# 1568880912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568880912 |
| Entity Type | Individual |
| Full Name | KEVIN SULLIVAN |
| Credential | RN |
| Practice Address |
66 Pavilion Ave Providence RI 02905-1522 |
| Practice Telephone | 4014619110 |
| Practice Fax Number | 4014619110 |
| Mailing Telephone | 4014619110 |
| Mailing Fax Number | 4014619110 |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA0400X |
Registered Nurse Specialization: Addiction (Substance Use Disorder) |
RN34014 | RI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356886998 | Kevin Doerr Sullivan | Physician Assistant | 208 Cedar Creek Ter, Ione, WA 99139-5011 | 2017-01-05 |
| 1750734992 | Kevin Sullivan | Specialist/Technologist | 936 Wynn Rd, Mcdonough, GA 30252-5802 | 2016-07-22 |
| 1457508996 | Kevin A. Sullivan | Counselor | 1500 W. Main St. Ste 300, Phoenix Counseling, Sun Prairie, WI 53590 | 2008-08-27 |
| 1770638066 | Kevin Patrick Sullivan | Dentist | 305 E 2nd Ave, Ellensburg, WA 98926-3315 | 2007-01-24 |
| 1447276225 | Kevin L. Sullivan | Radiology | 250 Ponce De Leon Ave, Suite 100, Decatur, GA 30030-3406 | 2006-07-14 |
| 1750940615 | Kevin Thomas Sullivan | Dentist | 1475 Pine Grove Rd Ste 107, Steamboat Springs, CO 80487-8851 | 2019-06-13 |
| 1275196172 | Kevin Sullivan | Behavior Technician | 1301 E Orangewood Ave, Anaheim, CA 92805-6807 | 2019-04-16 |
| 1194245662 | Kevin Brian Sullivan | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2017-06-26 |
| 1467806125 | Kevin Sullivan | Hospitalist | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2016-04-19 |
| 1023479839 | Kevin Sullivan | Occupational Therapist | 5006 Copper Ave Ne, Albuquerque, NM 87108-1301 | 2016-03-08 |
| Street Address |
66 PAVILION AVE |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-1522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174521488 | R.i.s.a.t., LLC | Clinic/Center | 66 Pavilion Ave, Providence, RI 02905-1522 | 2005-07-11 |
| 1366065898 | Stephanie Goncalves | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2020-05-19 |
| 1831736974 | Brandi J Mcdonnell | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2019-12-09 |
| 1396382347 | Wandali Perez | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2019-12-09 |
| 1811461403 | Alexander Tobias Jorrin | Physician Assistant | 66 Pavilion Ave, Providence, RI 02905-1522 | 2019-01-16 |
| 1083190086 | Natalia Navarro | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2018-07-13 |
| 1023505732 | Theresa Scibilia | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2018-04-18 |
| 1740702745 | Hannah Marie Park | Counselor | 66 Pavilion Ave, Providence, RI 02905-1522 | 2017-07-11 |
| 1336689637 | Robert Matuszek | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2017-03-06 |
| 1518407816 | Melanie Nelson | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2017-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 163WA0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063037364 | Phoenix Health Professional Group, LLC | Registered Nurse | 99 Wayland Ave Ste 100, Providence, RI 02906-4314 | 2020-06-11 |
| 1336689637 | Robert Matuszek | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2017-03-06 |
| 1518407816 | Melanie Nelson | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2017-03-06 |
| 1184179764 | Debra Figueira | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2016-08-24 |
| 1528443256 | Zoila Dasilva | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2015-07-23 |
| 1932596319 | Bryan Eliot Minor | Registered Nurse | 200 Butler Drive, Providence, RI 02906 | 2015-04-23 |
| 1578982963 | Meghan Anne Wood | Registered Nurse | 66 Pavilion Ave, Providence, RI 02905-1522 | 2014-04-14 |
| 1851654164 | Timothy Allen Smith | Registered Nurse | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2012-06-21 |
| 1235458100 | Linda Ann Jackson | Registered Nurse | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2010-05-18 |
| 1861635955 | Anne E Avelar | Registered Nurse | 830 Chalkstone Ave, Providence, RI 02908-4799 | 2009-04-20 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
Please comment or provide details below to improve the information on KEVIN 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.