Sullivan and PTRS

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SULLIVAN AND PTRS

Doing business as

Sullivan and Partners

Practice address

2204 Pavilion Dr Ste 108
Kingsport, TN 37660-4651

Phone

(423) 392-6100

Fax

(423) 392-0803

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Penny Leigh Lloyd

Title

Administrator

Phone

(423) 392-6100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sullivan and Partners Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Lynne Boatman, FNP-BC

  • Family Nurse Practitioner
  • Kingsport, TN
  • NPI 1629655063
  Medicare reassignment Care Compare group NPD
• James W Denham, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Kingsport, TN
  • NPI 1902088644
  Medicare reassignment Care Compare group NPD
• Priscilla Reece Pennings, FNP

  • Family Nurse Practitioner
  • Bristol, TN
  • NPI 1679313738
  Medicare reassignment Care Compare group NPD
• Michael Jude Sullivan, M.D.

  • Gastroenterology Physician
  • Kingsport, TN
  • NPI 1326023078
  Medicare reassignment Care Compare group NPD
• Sara Alexis Watson, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
  • NPI 1093558850
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1003981093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR STE 108",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604651",
            "telephone_number": "423-392-6100",
            "fax_number": "423-392-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR STE 108",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604651",
            "telephone_number": "423-392-6100",
            "fax_number": "423-392-0803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2204 Pavilion Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604651",
            "country_code": "US",
            "telephone_number": "423-392-6100",
            "fax_number": "423-392-0803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SULLIVAN AND PTRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "LLOYD",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-392-6100"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3703535",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "154366",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sullivandigestivecenter@directaddress.net",
            "affiliation": "Y",
            "endpointDescription": "direct message",
            "affiliationName": "Endoscopy Center of Kingsport",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2204 Pavilion Dr Ste 105",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376604651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sullivan and Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas E Sturdavant, MD
• Faith Sturgill
• Mechele Lea Stykes, HIS
• Meeradevi Sudarsanan, NP
• Viktor P Sulkowski, M.D.
• Sullivan County Regional Health Department
• Hugh M. Sullivan
• Lauren Sullivan, PHARMD
• Michael Jude Sullivan, M.D.
• Timothy James Sullivan Jr., M.D.

• Gastroenterology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.