Organization Active NPI

Lori a Sullivan MD LLC

  • Family Medicine Physician
  • West Jefferson, OH
National Provider Identifier
1083569966
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LORI A SULLIVAN MD LLC
Practice address
487 W Main St Ste B
West Jefferson, OH 43162-1178
Phone
(614) 454-7559
Fax
(614) 454-2989
NPI assigned
Mar 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Dr. Lori Sullivan, MDNPI 1417028697
Title
Physician/Owner
Phone
(614) 454-7559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

487 W Main St Ste B
West Jefferson, OH 43162-1178

Mailing address

487 W Main St Ste B
West Jefferson, OH 43162-1178
Phone (614) 454-7559

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2341379Lori a Sullivan MD LLC487 W Main Stree, Suite B, West Jefferson, OH 43162Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory

Locations

487 W Main St
Ste B
West Jefferson, OH 43162
Phone (380) 235-8070

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1083569966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 W MAIN ST STE B",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621178",
            "telephone_number": "614-454-7559",
            "fax_number": "614-454-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 W MAIN ST STE B",
            "city": "WEST JEFFERSON",
            "state": "OH",
            "postal_code": "431621178",
            "telephone_number": "614-454-7559",
            "fax_number": "614-454-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI A SULLIVAN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "614-454-7559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jefferson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.