Jerry E Sullins, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3056 Issued in TN

Practice address

104 Hazel Path
Hendersonville, TN 37075-3844

Phone

(615) 824-7220

NPI assigned

Aug 10, 2006

Last updated

Mar 20, 2008By the provider in NPPES

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 TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1073524807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HAZEL PATH",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753844",
            "telephone_number": "615-824-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HAZEL PATH",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753844",
            "telephone_number": "615-824-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLINS",
        "first_name": "JERRY",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "3056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Strive to Thrive LLC
• Kelly Struthers, OTD, OTR/L
• Denise F Stuart, M.D.
• Natalie Sturges
• Shaeli Suddarth
• Robert Sullivan, D.D.S.
• Sumner Chiropractic
• Sumner Imaging, LLC (Sumner Breast Imaging)
• Sumner Pediatrics, PLLC
• Sumner Physician Practices LLC (Michael C. Diaz, MD)

• General Practice Dentistry in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.