NPIMap

Organization Active NPI

James S Sullivan M.D. PA

  • Family Medicine Physician
  • Dothan, AL
National Provider Identifier
1083714042
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5184 Issued in AL
Legal business name
JAMES S SULLIVAN M.D. PA
Practice address
4300 Main St W
Suite 16
Dothan, AL 36301-1098
Phone
(334) 793-1038
Fax
(334) 615-8444
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Dr. James S Sullivan, M.D.
Title
Owner
Phone
(334) 793-1038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 5184 AL Primary

Addresses

Primary practice location

4300 Main St W
Suite 16
Dothan, AL 36301-1098

Mailing address

4300 Main St W
Suite 16
Dothan, AL 36301-1098
Phone (334) 793-1038

Other identifiers 1

IdentifierTypeStateIssuer
000010568MedicaidAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1083714042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MAIN ST W",
            "address_2": "SUITE 16",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011098",
            "telephone_number": "334-793-1038",
            "fax_number": "334-615-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MAIN ST W",
            "address_2": "SUITE 16",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011098",
            "telephone_number": "334-793-1038",
            "fax_number": "334-615-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES S SULLIVAN M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-793-1038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "5184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010568",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.