MR. TIMOTHY MARK SULLIVAN (NPI# 1619152915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619152915 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY MARK SULLIVAN |
| Credential | P.A. |
| Practice Address |
9951 E El Moro Ave Mesa AZ 85208-5869 |
| Mailing Address |
5432 E Southern Ave Mesa AZ 85206-2772 |
| Practice Telephone | 6025706428 |
| Mailing Telephone | 4803253275 |
| Mailing Fax Number | 4809819123 |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
| 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 |
| 1679559488 | Timothy E Sullivan | Chiropractor | 6101 Windcom Ct, Suite 300, Plano, TX 75093-7817 | 2005-12-22 |
| Street Address |
9951 E EL MORO AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85208-5869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588203723 | Southwest Cardiovascular Interventional Center, LLC | Clinic/Center | 7529 E Broadway, Mesa, AZ 85208 | 2020-01-06 |
| 1760021802 | Southwest Endovascular Center, LLC | Clinic/Center | 7529 E Broadway Rd, Mesa, AZ 85208 | 2020-01-06 |
| 1083116529 | Hailey Jo Kools | Specialist/Technologist | 11201 N Tatum Boulevard, Phoenix, AZ 85208 | 2018-03-01 |
| 1356881486 | Amber E Anderson | Nurse Practitioner | 1157 S Crismon Rd Ste 101, Mesa, AZ 85208 | 2017-03-08 |
| 1609264464 | Desert House Assisted Living LLC | Assisted Living Facility | 11055 E Grove St, Mesa, AZ 85208 | 2015-01-02 |
| 1366881872 | Freedom Az, LLC | Non-emergency Medical Transport (VAN) | 10682 E Oasis Dr, Mesa, AZ 85208 | 2013-06-18 |
| 1588922884 | Aaron David Hallstrom | Counselor | 158 S Hassett Cir, Mesa, AZ 85208 | 2012-04-25 |
| 1568604593 | David Berrey | Internal Medicine | 1917 South Crismon Rd., Mesa, AZ 85208 | 2009-04-06 |
| 1740475946 | Jackton Simiyu Khausi | Occupational Therapist | 7255 E Broadway, Mesa, AZ 85208 | 2007-09-11 |
| 1881896900 | Kate N Mullowney | Pharmacist | 10238 E Hampton Avenue, Suite 107, Mesa, AZ 85208 | 2007-06-01 |
| Find all providers in zip 85208 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734686 | Joshua Luke Adams | Physician Assistant | 5264 E Carol Ave, Mesa, AZ 85206-1304 | 2020-06-09 |
| 1508417957 | Joe Panelli | Physician Assistant | 524 S 88th St, Mesa, AZ 85208-8213 | 2019-09-26 |
| 1275183600 | Allie Finney | Physician Assistant | 4135 S Power Rd Ste 129, Mesa, AZ 85212-3627 | 2019-09-17 |
| 1972158459 | Jason Pearce | Physician Assistant | 8334 E Peralta Ave, Mesa, AZ 85212-1677 | 2019-08-01 |
| 1265086409 | Madison Ziser | Physician Assistant | 2604 E Downing Cir, Mesa, AZ 85213-6824 | 2019-07-25 |
| 1790341170 | Mark William Nelms | Physician Assistant | 4839 S Antonio, Mesa, AZ 85212-5191 | 2019-05-11 |
| 1235607292 | Amber Leeann Valenzuela | Physician Assistant | 2345 E Southern Ave Unit 101, Mesa, AZ 85204-5419 | 2018-11-07 |
| 1417423146 | Neda Yasmin Yanch | Physician Assistant | 2505 N Raven Cir, Mesa, AZ 85207-2063 | 2018-10-20 |
| 1336615590 | Nicholas J. Deyoung | Physician Assistant | 5058 E Southern Ave Ste 102, Mesa, AZ 85206-2771 | 2018-10-15 |
| 1417432063 | Jordan Tyler Foulger | Physician Assistant | 3248 E Jacinto Ave, Mesa, AZ 85204-7336 | 2018-09-29 |
| Find all providers in MESA | ||||
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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.