PHYLLIS L. SULLIVAN DO NPI 1386686434

NPI Information

NPI: 1386686434
Provider Name: PHYLLIS L. SULLIVAN, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
7405 RENNER RD
KU MEDWEST
SHAWNEE, KS
ZIP 66217
Phone: (913) 588-8400
Get Directions

Phyllis L. Sullivan, DO is a family medicine in Shawnee, KS. The provider is 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. Phyllis L. Sullivan, DO NPI is 1386686434. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7405 RENNER RD
KU MEDWEST
SHAWNEE, KS
ZIP 66217-414
Phone: (913) 588-8400
Fax: (913) 588-8413

The enumeration date for this NPI number is 6/12/2006 and was last updated on 9/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		R1H49	MISSOURI	No
2	207Q00000X	Family Medicine		05-24472	KANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	326972	OTHER		FIRSTGUARD
2	J610011A	MEDICARE PIN	KANSAS
3	4331498	OTHER		AETNA
4	C49934	MEDICARE UPIN
5	100231070B	MEDICAID	KANSAS
6	13470888	OTHER		BCBS
7	481159444	OTHER		JAYHAWK TAX ID
8	157695XX	OTHER		PREFERRED CARE OF NY
9	25562039	OTHER		BCBS KUMW UC
10	10001636401	OTHER		CHP PROVIDER NUMBER
11	P00052983	OTHER		RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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