Charles M Sullivan (NPI# 1144217530, PAC ID# 0840328746) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1144217530 |
| PAC ID by PECOS | 0840328746 |
| Professional Enrollment ID | I20100513001021 |
| Full Name | Charles M Sullivan |
| Organization Legal Name | OVERLAND PARK SURGICAL SPECIALTIES LLC |
| Address |
10100 W 119th St Suite 150 Overland Park KS 66213-4100 |
| Phone Number | 9137540061 |
| Gender | M |
| Medical School | UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE |
| Graduation Year | 1991 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9234318502 |
| Number of Group Practice Members | 131 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170176 | OVERLAND PARK REG MED CTR |
| 170040 | UNIVERSITY OF KANSAS HOSPITAL |
| 170049 | OLATHE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10100 W 119th St, Suite 150, Overland Park, KS 66213-4100 | 9137540061 | OVERLAND PARK SURGICAL SPECIALTIES LLC |
| Organization Legal Name | OVERLAND PARK SURGICAL SPECIALTIES LLC |
| Physicians | 129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nida Gursel Dillon | Family Medicine | Overland Park Surgical Specialties LLC | 11725 W 112th St, Overland Park, KS 66210-2761 |
| Jeremy B Kirchoff | Family Medicine | Overland Park Surgical Specialties LLC | 12210 W 87th St Pkwy, Lenexa, KS 66215-2834 |
| Coedy S Walker | Physical Therapy | Overland Park Surgical Specialties LLC | 11164 S Noble Dr, Olathe, KS 66061-7572 |
| Jessica M Blake | Nurse Practitioner | Overland Park Surgical Specialties LLC | 15101 Glenwood Ave, Stanley, KS 66223-3154 |
| Amy M Schleper | Registered Dietitian Or Nutrition Professional | Overland Park Surgical Specialties LLC | 10100 W 119th St, Suite 150, Overland Park, KS 66213-4100 |
| Ngoc-lan Thi Nguyen | Family Medicine | Overland Park Surgical Specialties LLC | 10600 Mastin St, Overland Park, KS 66212-5723 |
| Christopher D Wright | Family Medicine | Overland Park Surgical Specialties LLC | 1803 S Ridgeview Rd, Olathe, KS 66062-2376 |
| Young J Cho | Family Medicine | Overland Park Surgical Specialties LLC | 801 N Mur Len Rd, Suite 211, Olathe, KS 66062-1794 |
| Michael A Sabolovic | Physical Therapy | Overland Park Surgical Specialties LLC | 10500 Quivira Rd, Overland Park, KS 66215-2306 |
| Sofia M Bacon | Physical Therapy | Overland Park Surgical Specialties LLC | 10600 Mastin St, Overland Park, KS 66212-5723 |
| Street Address |
10100 W 119TH ST SUITE 150 |
| City | OVERLAND PARK |
| State | KS |
| Zip | 66213-4100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy M Schleper | Registered Dietitian Or Nutrition Professional | Overland Park Surgical Specialties LLC | 10100 W 119th St, Suite 150, Overland Park, KS 66213-4100 |
| Jessica Richter | Family Medicine | Overland Park Surgical Specialties LLC | 10100 W 119th St, Suite 150, Overland Park, KS 66213-4100 |
| Keith A Warren | Ophthalmology | 10100 W 119th St, Suite 260, Overland Park, KS 66213-4100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristin M Pierce | Optometry | Overland Park Eye Center Inc | 7500 W 119th St, Overland Park, KS 66213-1108 |
| Joseph M Schwerdtfeger | Optometry | Overland Park Eye Center Inc | 7500 W 119th St, Overland Park, KS 66213-1108 |
| Victoria Lee Rebman | Chiropractic | 7108 W 119th St, Overland Park, KS 66213-1116 | |
| Bradley E Davis | Urology | Urologic Surgery Associates, Pa | 12330 Metcalf Ave, Suite 100, Overland Park, KS 66213-1301 |
| Molly Beth Harris | Nurse Practitioner | Saint Lukes Physician Group Inc | 12330 Metcalf Ave, Suite 260, Overland Park, KS 66213-1302 |
| Felicia D Menefee | Clinical Nurse Specialist | Saint Luke's Physician Group I, LLC | 12330 Metcalf Ave, Suite 280, Overland Park, KS 66213-1302 |
| Richard B Price | Otolaryngology | 12330 Metcalf Ave, Suite 550, Overland Park, KS 66213-1305 | |
| Kristin J Marhee | Nurse Practitioner | Saint Lukes Physician Group Inc | 12330 Metcalf Ave, Suite 560, Overland Park, KS 66213-1305 |
| Mignon M Makos | Neurology | Saint Lukes Physician Group Inc | 12330 Metcalf Ave, Suite 420, Overland Park, KS 66213-1307 |
| Peter J Caruso | Obstetrics/gynecology | Saint Lukes Physician Group Inc | 12330 Metcalf Ave, Suite 420, Overland Park, KS 66213-1307 |
| Find all physicians in zip 66213 | |||
| City | OVERLAND PARK |
| Zip Code | 66213 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | OVERLAND PARK + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.