Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053341370 Individual Practitioner Male Practitioner

Dr. Jon M. Sullivan , MD

Pediatrics • Gallipolis, OH

Professional Overview & Biography Verified Profile Summary

Dr. Jon Sullivan, MD is a registered healthcare professional specializing in Pediatrics in Gallipolis, OH. Practice services are available at 100 JACKSON PIKE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

100 Jackson Pike

Gallipolis, OH 456311560

Telephone 7404465371
Fax 7404465711
Associated Practice Facility / Clinic
🏢 Holzer Clinic, Llc Facility NPI 1508817248

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Gallipolis, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.0 Yrs
State Avg: 20.0 Yrs
Regional Practice Density
16 Specialists

Practicing in Gallipolis, OH (3057 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-12-29
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OH 35-05-4754

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License WV 16987

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0882719 (OH)
Medicaid State Provider ID
0107833000 (WV)
Commercial Insurance / Payer ID Molina Medicaid #
0882719 (OH)
Commercial Insurance / Payer ID Anthem Bcbs
000000006810 (WV)
Commercial Insurance / Payer ID Rr Medicare
370002760 (OH)
Commercial Insurance / Payer ID Anthem Bcbs
000000007592
Commercial Insurance / Payer ID Unison Medicaid #
000000181879 (OH)
Commercial Insurance / Payer ID Caresource Medicaid #
310917085065 (OH)
Commercial Insurance / Payer ID Mountain State Bcbs
001714064

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
NPI 1063890200

Doctor of Medicine (M.D.)

Joanna Miller , CNP

Nurse Practitioner - Family

NPI 1073894242

Certified Nurse Practitioner

Marina Burgess , FNP-C

Nurse Practitioner

NPI 1083588370

Family Nurse Practitioner (Certified)

NPI 1144424698

Doctor of Medicine (M.D.)

NPI 1225082670

Doctor of Medicine (M.D.)

NPI 1255362927

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location October 25, 2019

Registered at 100 JACKSON PIKE, GALLIPOLIS, OH 456311560 (Tel: 7404465371)

NPI Profile Active February 09, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location February 09, 2015

Registered at 90 JACKSON PIKE, GALLIPOLIS, OH 456311560 (Tel: 7404465371)

📍
Updated Business Mailing Address February 09, 2015

Registered at 90 JACKSON PIKE, GALLIPOLIS, OH 456311560 (Tel: 7404465371)

👤
Provider Name / Credentials Updated February 09, 2015

Recorded as JON SULLIVAN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 09, 2015

Pediatrics (License #35-05-4754 in OH)

🟢
Initial NPI Registration & Enumeration July 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053341370
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2006
Last Update: December 29, 2020
Sole Proprietor: No

Mailing Address

90 Jackson Pike

Gallipolis, OH 456311560

Phone: 7404465371

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.