Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kellen A. Sullivan, MD

Individual provider Internal Medicine Physician · NPI 1003479270

Kellen A. Sullivan, MD is an Internal Medicine in Salt Lake City, Utah. Graduated from Ohio State University College of Medicine in 2019, 7 years ago. Practices with Legacy Salmon Creek Hospital, a 313-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
7
Trained at
Ohio State University College of Medicine
Licensed in
UT
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

30 N 1900 E Rm 4C116
Salt Lake City, UT 84132-0002
Phone: (801) 581-7606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 11898972-1205 (UT)

Record details

NPI number1003479270
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2019
Last updated in NPPESAugust 24, 2020
Certification dateAugust 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Legacy Salmon Creek Hospital — 313 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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