SULLIVAN FAMILY PRACTICE, LLC (NPI# 1770502981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770502981 |
| Entity Type | Organization |
| Organization Name | SULLIVAN FAMILY PRACTICE, LLC |
| Practice Address |
2229 Mary Sherman Dr Sullivan IN 47882-7633 |
| Mailing Address |
2229 Mary Sherman Dr Po Box 230 Sullivan IN 47882-7633 |
| Practice Telephone | 8122683318 |
| Practice Fax Number | 8122684017 |
| Mailing Telephone | 8122683318 |
| Mailing Fax Number | 8122684017 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-10-26 |
| Authorized Official Name | MRS. SUSAN LYNN HELMAN (ADMINISTRATOR) |
| Authorized Official Telephone | 8122683318 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
01036108 | IN | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | 01036108 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RURAL HEALTH CLINIC | 153868 | 01 |
| IN | 200015680A | 05 |
| Street Address |
2229 MARY SHERMAN DR |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882-7633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304123 | Carl F. Conwell | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2005-05-23 |
| 1447805965 | Sullivan County Community Hospital | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2019-08-02 |
| 1073042131 | Jeanna Rennee Lisman | Nurse Practitioner | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2017-06-12 |
| 1700256948 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2015-09-30 |
| 1811317977 | Mso Clinics, Inc. | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2014-04-16 |
| 1467884643 | Sullivan County Community Hospital | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2013-07-30 |
| 1316270747 | Union Associated Physicians Clinic, LLC | Otolaryngology | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2009-09-17 |
| 1053576405 | Terri Lee Brown | Nurse Practitioner | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2008-07-25 |
| 1427275353 | Jessy G. Woods | Internal Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2007-04-20 |
| 1174675789 | Kidney and Hypertension Center of In | Internal Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2007-01-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1003838194 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 505 West Wolfe Street, Sullivan, IN 47882 | 2006-07-24 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
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| 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 |
|---|---|---|---|---|
| 1568628915 | Barbara Ann Reed | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2008-08-05 |
| 1922295815 | Patients First Health Care LLC | Family Medicine | 102 Grande Ctr, Sullivan, MO 63080-1266 | 2007-09-25 |
| 1548337942 | Premier Health Center, L.L.C. | Family Medicine | 102 Progress Pkwy, Sullivan, MO 63080-2359 | 2006-11-29 |
| 1578633194 | Mary Ann Chavez | Family Medicine | 1120 N Section St, Sullivan Medical Clinic, Sullivan, IN 47882-9200 | 2006-11-09 |
| 1912924630 | Medical Income Management Corp | Family Medicine | 101 W Jefferson St, Sullivan, IL 61951-1914 | 2006-07-17 |
| 1457393712 | Matthew J Tiefenbrunn | Family Medicine | 1326 S Service Rd W Ste 10, Sullivan, MO 63080-2306 | 2006-06-12 |
| 1811973944 | Yasuo Ishida | Family Medicine | 102 Progress Pkwy # A, Sullivan, MO 63080-2359 | 2005-12-20 |
| 1477555738 | Glen E Dust | Family Medicine | 2 W Adams St, Sullivan, IL 61951-1943 | 2005-06-01 |
| 1952304123 | Carl F. Conwell | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2005-05-23 |
| 1497363303 | Sullivan County Community Hospital | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-16 |
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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.