Matthew Patrick Sullivan, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200100611 Issued in NC

Practice address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Phone

(910) 450-4159

Fax

(910) 450-4194

NPI assigned

Apr 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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

• Kinston Physicians Group, PLLC

  • Emergency Medicine Physician
  • Kinston, NC
  • NPI 1689923757
  NPD
• Emergency Medicine Physicians of Carteret County, PLLC

  • Emergency Medicine Physician
  • Morehead City, NC
  • NPI 1538108535
  NPD (past)
• Emergency Medicine Physicians of Craven County, PLLC

  • Emergency Medicine Physician
  • New Bern, NC
  • NPI 1164462586
  NPD (past)
• Golden Grove Emergency Physicians

  • Emergency Medicine Physician
  • Kenansville, NC
  • NPI 1710063144
  NPD (past)
• National Emergency Services North Carolina Inc

  • Emergency Medicine Physician
  • Kenansville, NC
  • NPI 1063493484
  NPD (past)
• Onslow Memorial Hospital Inc

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  NPD (past)
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1003879008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MATTHEW",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200100611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912937",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Stringer
• Kristy Dyan Stroble, PHYSICAL THERAPIST
• Terry Lee Stuart, PA-C
• Valerie L Styron, RDH
• Graham Edward Sullivan, M.D.
• Derek R Summers, IDC
• Melissa Ann Summerville, CNM
• Sunland Optical Co., Inc.
• Gail Louise Surrena, RN, MSN
• Nancy Lee Swansiger, RN, BSN

• Emergency Medicine Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.