Brian Keith Sullivan, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT005008 Issued in GA

Practice address

326 Starbridge Rd
Murrayville, GA 30564-2817

Phone

(706) 265-9530

Fax

(706) 867-7969

NPI assigned

Apr 10, 2012

Last updated

Apr 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Starbridge Chiropractic, Inc.

  • Chiropractor
  • Murrayville, GA
  • NPI 1942545280
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1003172438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 STARBRIDGE RD",
            "city": "MURRAYVILLE",
            "state": "GA",
            "postal_code": "305642817",
            "telephone_number": "706-265-9530",
            "fax_number": "706-867-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 STARBRIDGE RD",
            "city": "MURRAYVILLE",
            "state": "GA",
            "postal_code": "305642817",
            "telephone_number": "706-265-9530",
            "fax_number": "706-867-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT005008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Andrew Henderson, D.C.
• Hope in Harmony, LLC
• Premise Health of Georgia Medical PC (Fieldale Quick Care Murrayville)
• Andrew Singleton
• Starbridge Chiropractic, Inc.
• Amy Deann Young, LPC

• Massage Therapist in Murrayville, GA
• Providers in Murrayville, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.