THOMAS P SULLIVAN (NPI# 1720056393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720056393 |
| Entity Type | Individual |
| Full Name | THOMAS P SULLIVAN |
| Credential | MD |
| Practice Address |
160 Valley Dr Lodi WI 53555-1464 |
| Practice Telephone | 6085923296 |
| Mailing Telephone | 6085923296 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2010-06-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 19926 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31037600 | 05 | |
| WI | RAILROAD MEDICARE | 080075917 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487203386 | Thomas Carson Bruyer Sullivan | Physical Therapist | Bst Granite Falls, 345 10th Avenue, Granite Falls, MN 56241 | 2019-09-04 |
| 1992156426 | Thomas Patrick Sullivan | Counselor | 5 Prentiss Pl, Medfield, MA 02052-1652 | 2016-06-27 |
| 1437565488 | Thomas Barrett Sullivan | Orthopaedic Surgery | 1611 W Harrison St Ste 201, Chicago, IL 60612-4861 | 2014-07-09 |
| 1508104373 | Thomas Sullivan | Psychiatry & Neurology | 16321 Mack Ave, Detroit, MI 48224-2756 | 2013-01-29 |
| 1003033283 | Thomas Edward Sullivan | Dentist | 1200 High Ridge Parkway, Westchester, IL 60154 | 2007-04-19 |
| 1215064050 | Thomas Edward Sullivan | Pharmacist | 1010 S. Ponce Deleon Blvd, Winn-dixie Pharmacy, St Augustine, FL 32084 | 2007-02-28 |
| 1447391222 | Thomas Paul Sullivan | Counselor | 6 Cedarview Rd, Ipswich, MA 01938-1604 | 2007-02-12 |
| 1871630111 | Thomas E Sullivan | Internal Medicine | 6 Brackenbury Ln, Beverly, MA 01915-3822 | 2007-01-30 |
| 1548379233 | Thomas S Sullivan | Chiropractor | 481 Ferry St, Malden, MA 02148-7851 | 2006-08-29 |
| 1780691253 | Thomas Ryan Sullivan | Chiropractor | 7106 Pippin Rd, Cincinnati, OH 45239 | 2006-08-01 |
| Street Address |
160 VALLEY DR |
| City | LODI |
| State | WI |
| Zip Code | 53555-1464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225003445 | Sauk Prairie Healthcare Inc | Clinic/Center | 160 Valley Dr, Lodi, WI 53555-1464 | 2006-02-21 |
| 1811550809 | Jillian Troxel | Physical Therapist | 160 Valley Dr, Lodi, WI 53555-1464 | 2019-04-16 |
| 1528386703 | David P Krey | Family Medicine | 160 Valley Dr, Lodi, WI 53555-1464 | 2010-05-12 |
| 1881719284 | Karen M Meng | Nurse Practitioner | 160 Valley Dr, Lodi Medical Clinic, Lodi, WI 53555-1464 | 2007-03-21 |
| 1124085584 | Andrea M Chao | Pediatrics | 160 Valley Dr, Lodi, WI 53555-1464 | 2006-04-28 |
| 1346215241 | David J Eberdt | Physician Assistant | 160 Valley Dr, Lodi, WI 53555-1464 | 2006-02-22 |
| 1508831413 | Dale P Fanney | Family Medicine | 160 Valley Dr, Lodi, WI 53555-1464 | 2006-02-22 |
| 1164497095 | Deanna C Lord | Physician Assistant | 160 Valley Dr, Lodi, WI 53555-1464 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730722208 | Cara Kjorlie | Licensed Practical Nurse | W12277 Cty J, Lodi, WI 53555 | 2019-10-28 |
| 1437282795 | Perry Allen Barrette | Dentist | 204 Pond St, Lodi, WI 53555 | 2007-03-14 |
| 1467417576 | Rian J Podein | Family Medicine | 160 Valley Drive, Lodi, WI 53555 | 2006-04-20 |
| 1992789523 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 700 Clark St, Lodi, WI 53555-1010 | 2005-12-06 |
| 1730643123 | Divine Rehabilitation and Nursing At Lodi LLC | Skilled Nursing Facility | 700 Clark St, Lodi, WI 53555-1010 | 2019-01-30 |
| 1467719203 | Colleen R Jones | Occupational Therapy Assistant | 700 Clark St, Lodi, WI 53555-1010 | 2012-04-18 |
| 1851545966 | Jean Elizabeth Gates | Occupational Therapist | 700 Clark St, Lodi, WI 53555-1010 | 2008-11-17 |
| 1376743385 | Marcie Marie Wenzel | Occupational Therapy Assistant | 700 Clark St, Lodi, WI 53555-1010 | 2007-07-19 |
| 1255531190 | Michelle Marie Kaschinske | Occupational Therapist | 700 Clark St, Lodi, WI 53555-1010 | 2007-07-19 |
| 1285828749 | Lodi School District | Local Education Agency (LEA) | 115 School St, Lodi, WI 53555-1046 | 2007-08-28 |
| Find all providers in zip 53555 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588919716 | Tareq A Ali Md Apc | Family Medicine | 1520 W Kettleman Ln Ste B, Lodi, CA 95242-9290 | 2012-07-13 |
| 1609147354 | Ruby Kaur Gill | Family Medicine | 999 S Fairmont Ave Ste 235, Lodi, CA 95240-5100 | 2012-01-25 |
| 1114147212 | Frank Silvio Alvarado | Family Medicine | 830 S Ham Lane, Suite 30, Lodi, CA 95240 | 2007-04-30 |
| 1568480556 | Carina Fabiana Gonzalez | Family Medicine | 1300 W Lodi Ave Ste P, Lodi, CA 95242-3038 | 2006-07-17 |
| 1437177755 | Valerie J. Kidd | Family Medicine | 845 S Fairmont Ave Ste 8, Lodi, CA 95240-5113 | 2006-07-17 |
| 1578506952 | Harvey Hashimoto | Family Medicine | 2415 W Vine St, Suite 105, Lodi, CA 95242-3731 | 2006-06-14 |
| 1790722718 | Tareq Ali | Family Medicine | 1520 W Kettleman Ln, Suite B, Lodi, CA 95242-9290 | 2006-05-31 |
| 1497712152 | Maria Elena Saluta-ferrer | Family Medicine | 1335 S Fairmont Ave, Lodi, CA 95240-5520 | 2006-04-27 |
| 1467417576 | Rian J Podein | Family Medicine | 160 Valley Drive, Lodi, WI 53555 | 2006-04-20 |
| 1790765386 | Kimberly C Sheets | Family Medicine | 225 Elyria St, Lodi, OH 44254 | 2006-01-19 |
| Find all providers in LODI | ||||
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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.