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THEODORE K. SULLIVAN O.D., NPI 1437153772

Optometrist in BALLWIN, MO

Last Updated on : Oct 26,2017

About THEODORE K. SULLIVAN (NPI 1437153772)


THEODORE K. SULLIVAN is an Optometrist provider in BALLWIN, United States. His medical specialization is Optometrist .

1437153772 is NPI number of THEODORE K. SULLIVAN.

THEODORE K. SULLIVAN's primary taxonomy code based on NPI Lookup is 152W00000X with license number T02915. This taxonomy code refers to Optometrist.

THEODORE K. SULLIVAN has more than 16 years of experience.

THEODORE K. SULLIVAN current practice location address is 15933 CLAYTON RD STE 201, BALLWIN, MO. THEODORE K. SULLIVAN can be reached out via phone at 636-200-4393 and via fax at 636-527-0766 .

You can also correspond with THEODORE K. SULLIVAN through mail at mailing address 3071 PHOENIX CENTER DR, WASHINGTON, MO, United States. Mailing address contact number is 636-777-2345.

The enumeration date of THEODORE K. SULLIVAN is 01-Jun-2005. The provider is registered as an Individual and the NPI record was last updated 5 years ago.

1437153772 NPI Information

Name THEODORE K. SULLIVAN
National Provider Id (NPI) 1437153772
Entity Type Individual
Gender M
Credential O.D.
Practice Address 15933 CLAYTON RD STE 201,
BALLWIN, MO, United States
Practice Telephone 636-200-4393
Practice Fax Number 636-527-0766
Mailing Address 3071 PHOENIX CENTER DR ,
WASHINGTON, MO, United States
Mailing Telephone 636-777-2345
Mailing Fax Number 636-777-2115
Enumeration Date 01-Jun-2005
Last Updated Date 26-Oct-2017

THEODORE K. SULLIVAN (NPI 1437153772) Primary Taxonomy Information

Primary Taxonomy Code Clasification License Number License State
Y 152W00000X Optometrist T02915 MO

Additional Identifiers

Identifier Type/Code Identifier State Identifier Issuer
004009024 MEDICARE ID-Type Unspecified (04) MO
U12668 MEDICARE UPIN (02) MO

THEODORE K. SULLIVAN (NPI 1437153772) Office Location

Providers in same location

NPI Name Taxonomy Address Enumeration date
1457882227 SAKSHI MATHUR DHAR Student in an Organized Health Care Education/Training Program 3901 RAINBOW BLVD # MS 2005,
KANSAS CITY, KS, United States
23-Mar-2017
1205309234 HEATHER RENEE LEONE Nurse Practitioner, Family 452 SOVEREIGN COURT SUITE A,
BALLWIN, MO, United States
02-Jan-2019
1669539987 JEFFREY ALEXANDER Anesthesiology 351 CONSORT DR,
BALLWIN, MO, United States
03-Jan-2007
1053909382 GERMAIN ZARKA Pharmacist 14400 CLAYTON RD,
BALLWIN, MO, United States
03-Jan-2021
1245218924 PUSHPA BISARYA Emergency Medicine 5471 DR MARTIN LUTHER KING DR,
SAINT LOUIS, MO, United States
04-Jan-2006
1720135833 LISA ANN CIAMPOLI Nurse Anesthetist, Certified Registered 13523 BARRETT PARKWAY DRIVE, SUITE 104
BALLWIN, MO, United States
04-Jan-2007
1811044506 CYNTHIA JEAN LUCAS Optometrist 118 RAMSEY LN,
BALLWIN, MO, United States
04-Jan-2007
1497802854 KRISTY A THOMSON Chiropractor 239 RIES RD,
BALLWIN, MO, United States
05-Jan-2007
1902313372 JENNIFER C COFFIN Behavior Analyst 9510 PAGE AVE,
SAINT LOUIS, MO, United States
05-Jan-2018
1417618059 JENNIFER K KEMP Nurse Practitioner, Psych/Mental Health 12303 DE PAUL DR,
BRIDGETON, MO, United States
05-Jan-2022
1265410419 MARY J DUPARRI Counselor, Professional 349 WOODRUN DR,
BALLWIN, MO, United States
06-Jan-2006
1366987992 NADIA MELENDEZ Physical Therapy Assistant 13610 BARRETT OFFICE DR, 210
BALLWIN, MO, United States
06-Jan-2017
1326687468 PAISLEY HARPER Anesthesiologist Assistant 339 CONSORT DR,
BALLWIN, MO, United States
06-Jan-2020
1053909960 TOTAL ACCESS URGENT CARE, PC Clinic/Center, Urgent Care 13861 MANCHESTER RD,
BALLWIN, MO, United States
06-Jan-2021
1366988891 THERESA JOY HASTING Nurse Practitioner, Women's Health 1727 HIGHVIEW CIRCLE CT,
BALLWIN, MO, United States
08-Jan-2017
1831249259 DESPINA (PENNY) ANGELA KYRAMARIOS Speech-Language Pathologist, 1003 CLAYTONBROOK DR,
BALLWIN, MO, United States
10-Jan-2007
1285784470 MATTHEW P. CLINE Dentist, General Practice 14560 MANCHESTER RD, SUITE 25
BALLWIN, MO, United States
11-Jan-2007
1659421303 IRA NATHAN ETTINGER Optometrist, Corneal and Contact Management 1229 WISSMANN DR,
BALLWIN, MO, United States
12-Jan-2007
1871643718 KAYCE A STROHMEYER Optometrist 352 S BROADVIEW ST,
CAPE GIRARDEAU, MO, United States
11-Jan-2007
1780273144 NATALIE UNDERBERG Chiropractor 101 GOLD DR,
FORISTELL, MO, United States
11-Jan-2021

FAQs

Whose NPI Number is 1437153772?

1437153772 is the NPI number of THEODORE K. SULLIVAN.

What is the specialty for THEODORE K. SULLIVAN?

The Specialty of THEODORE K. SULLIVAN is Optometrist.

NPI number meaning

Field Name Field Value
NPI 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code.
Provider Business Mailing Address Telephone Number The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider Business Practice Location Address Telephone Number The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number The fax number associated with the location address of the provider being identified.
Provider Enumeration Date The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date The date that a record was last updated or changed.
Authorized Official Telephone Number The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy Taxonomy Description of the Healthcare Provider.
Provider License Number Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
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