THEODORE K SULLIVAN, OD, LLC - NPI 1790641884

Q: What is Theodore K Sullivan, Od, LLC's NPI number?

The NPI number for Theodore K Sullivan, Od, LLC is 1790641884. It was assigned to this organization in the NPPES registry on January 2, 2026.

Q: What is Theodore K Sullivan, Od, LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

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About Theodore K Sullivan, Od, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE K SULLIVAN, OD, LLC (NPI 1790641884) is a healthcare organization registered as an optometrist in Ballwin, Missouri and active in the NPI registry since January 2026. The organization lists Theodore K Sullivan, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1790641884

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameTHEODORE K SULLIVAN, OD, LLC

Location Address1 MERAMEC BLUFFS DRBallwin, MO 63021-3309

Mailing Address9015 Eager Rd Apt 119Saint Louis, MO 63144-1109 · (314) 478-3669

Phone(636) 861-0600

Organization SubpartNo

Authorized OfficialTheodore K SullivanOptometrist · (314) 478-3669

Enumeration DateJanuary 2, 2026

NPPES CertifiedJanuary 1, 2026

✔ NPI 1790641884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1 MERAMEC BLUFFS DR, Ballwin, MO 63021

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MELANIE KORNBLUM OTR/L

Occupational Therapist