Gary J Sullivan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1757 Issued in NC

Practice address

30 Semora Rd
Roxboro, NC 27573-6201

Phone

(336) 599-6771

Fax

(336) 599-6494

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

No

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 NC

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 1984

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 and National Provider Directory roles.

• Sullivan Chiropractic Clinic

  • Chiropractor
  • Roxboro, NC
  • NPI 1104808385
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1083820740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1091",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275731091",
            "telephone_number": "336-599-6771",
            "fax_number": "336-599-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SEMORA RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275736201",
            "telephone_number": "336-599-6771",
            "fax_number": "336-599-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernestine Stewart, LPC-A, LCAS-A, LGPC
• Benedict John Stover, P.T.A.
• Kenneth Francis Strachan Jr., M.D.
• Scott A Strine, MD
• Sullivan Chiropractic Clinic
• Susan Durham
• Linda M Sutton, MD
• Brian James Swift, DDS
• Teresa Johnson
• Kelcie Renae Thames, DNP-C

• Chiropractor in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.