Sullivan Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1757 Issued in NC

Legal business name

SULLIVAN CHIROPRACTIC CLINIC

Practice address

30 Semora Rd
Roxboro, NC 27573-6201

Phone

(336) 599-6771

Fax

(336) 599-6494

NPI assigned

Nov 15, 2005

Organization subpart

No

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

Authorized official

Name

Gary J Sullivan, DCNPI 1083820740

Title

Gen Partner

Phone

(336) 599-6771

Specialties & licenses 1

Addresses

Other names 1

• Gary J Sullivan DC Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Gary J Sullivan, D.C.

  • Chiropractor
  • Roxboro, NC
  • NPI 1083820740
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1104808385",
    "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": {
        "organization_name": "SULLIVAN CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "GEN PARTNER",
        "authorized_official_telephone_number": "336-599-6771",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary J Sullivan DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• SRFC, Inc.
• Ernestine Stewart, LPC-A, LCAS-A, LGPC
• Benedict John Stover, P.T.A.
• Kenneth Francis Strachan Jr., M.D.
• Scott A Strine, MD
• Gary J Sullivan, D.C.
• Susan Durham
• Linda M Sutton, MD
• Brian James Swift, DDS
• Teresa Johnson

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.