Richard Edward Sullivan Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4186 Issued in OH

Practice address

701 Beta Dr
Suite 18
Mayfield Village, OH 44143-2367

Phone

(773) 573-6525

NPI assigned

Sep 6, 2011

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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Chiropractic

Education

National University of Arts and Sciences, Medical Department, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River's Edge Chiropractic LLC

  • Chiropractor
  • Mayfield Village, OH
  • NPI 1699223966
  Medicare reassignment Authorized official
• Mid States Chiropractic of Euclid Road Health Care

  • Chiropractor
  • Willoughby, OH
  • NPI 1881635829
  NPD

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1063793933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BETA DR",
            "address_2": "SUITE 18",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432367",
            "telephone_number": "773-573-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BETA DR",
            "address_2": "SUITE 18",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441432367",
            "telephone_number": "773-573-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Allison Soshnik
• Katherine C Southall
• Ellen M. Spraggins, PAC, M.P.A.S
• Rebecca I Streem, LISW
• Leah Strom, SLP
• Heidi M Tarro, PT
• Candice Taylor, BCBA
• Michael Teichman, LISW-S
• Grace Titgemeier, CT
• Gina Torok, RBT

• Chiropractor in Mayfield Village, OH
• Providers in Mayfield Village, OH by specialty
• Chiropractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.