Justin L Sullivan, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

201301701 Issued in NC

Practice address

810 Fairgrove Church Rd
Hickory, NC 28602-9617

Phone

(828) 326-3000

NPI assigned

Mar 30, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Hospitalist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catawba Valley Medical CenterGroup PAC ID 0547178907, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Catawba Valley Medical Center

  dba CVMC Maternity Services

  • Obstetrics Physician
  • Hickory, NC
  • NPI 1285929554
  Medicare reassignment Care Compare group NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc.

  dba Cannon Inpatient Physician Group

  • Hospitalist Physician
  • Linville, NC
  • NPI 1821403957
  Medicare reassignment NPD
• Catawba Valley Medical Center

  • Health Educator
  • Hickory, NC
  • NPI 1518524818
  NPD
• Catawba Valley Medical Center

  dba Catawba Valley Hospitalists

  • Hospitalist Physician
  • Hickory, NC
  • NPI 1639123979
  NPD
• Charles a Cannon Jr Memorial Hospital Inc

  dba Cannon Inpatient Behavioral Health

  • Psychiatric Hospital Unit
  • Linville, NC
  • NPI 1407006968
  NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc

  • Certified Registered Nurse Anesthetist
  • Linville, NC
  • NPI 1346302783
  NPD
• Charles a. Cannon, Jr. Memorial Hospital, Inc.

  • Cardiovascular Disease Physician
  • Linville, NC
  • NPI 1477006385
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catawba Valley Medical Center

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1164495255
  Care Compare affiliation

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1023307139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JUSTIN",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "PERMIT",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201301701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Suddreth
• Gregory Suddreth
• James Andrew Sugg, D.D.S.
• Parker Suit, DO
• Brian David Sullivan, DO
• Lindsay Nicole Sullivan, PHARMD
• Kenneth V Summer, M.D.
• Valarie Crisp Summerow, MSN, ANPBC
• Shane O Summers, M.D.
• Summit Medical Carolinas PLLC

• Internal Medicine Physician in Hickory, NC
• Providers in Hickory, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.
• 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.