James J Sullivan DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101004290 Issued in MI

Legal business name

JAMES J SULLIVAN DO PC

Practice address

105 W 5TH St
Gladwin, MI 48624-1162

Phone

(517) 426-4521

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

James J Sullivan, DO

Title

Owner

Phone

(517) 426-4521

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1043249725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 CHRISTY WAY",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032267",
            "telephone_number": "989-791-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 5TH ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486241162",
            "telephone_number": "517-426-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES J SULLIVAN DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-426-4521",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101004290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1039903",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexys Sue Homan
• Peyton Joi Hubel
• Gregory Kyle Hughes, PT, DPT
• Joel D Humphrey, M.D.
• Chelsea Hutchinson
• Candi S Johnson
• Ruth Johnson
• Skyler Johnson
• Margaret Ann Joslin, R.N.
• Kandarp K. Vora, MD PC

• Family Medicine Physician in Gladwin, MI
• Providers in Gladwin, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.