Harold Hayes Sullivan Jr., MD, MPH

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME106620 Issued in FL

Practice address

700 Zeagler Dr
Suite 8
Palatka, FL 32177-6806

Phone

(386) 328-4242

Fax

(386) 328-4244

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• North Florida Acute Care Specialists LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1245489038
  NPD (past)
• North Florida Gastroenterology LLC

  • Gastroenterology Physician
  • Orange Park, FL
  • NPI 1275725343

  Gastroenterology

  NPD (past)
• Putnam Physician Practices, LLC

  • Orthopaedic Surgery Physician
  • Palatka, FL
  • NPI 1780957944
  NPD (past)
• Casco Bay Endoscopy

  • Ambulatory Surgical Clinic/Center
  • South Portland, ME
  • NPI 1538139001
  NPD (past)
• Casco Bay Gastroenterology LLC

  • Gastroenterology Physician
  • South Portland, ME
  • NPI 1972579241

  Gastroenterology

  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1013987635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ZEAGLER DR",
            "address_2": "SUITE 8",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776806",
            "telephone_number": "386-328-4242",
            "fax_number": "386-328-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ZEAGLER DR",
            "address_2": "SUITE 8",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776806",
            "telephone_number": "386-328-4242",
            "fax_number": "386-328-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "HAROLD",
        "middle_name": "HAYES",
        "name_suffix": "Jr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME106620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004179900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen L. Beckett, DDS, PA
• Alice A. Stephens, L.C.S.W.
• Joseph Dean Stillword, MD
• John Sanders Stoltz, M.D.
• Abigale Rose Such, OTR
• Joseph Wynn Sullivan, D.O.
• Sunrise Primary Care Inc
• Sunrise Primary Care Inc
• Siva Suryadevara, M.D.
• Kathleen Marie Tanner, LMT, LPN

• All providers in Palatka, FL
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.