Sean Sullivan, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Practice address

John Paul Jones Circle
Department of Pediatrics
Portsmouth, VA 23708-2197

Phone

(757) 953-7550

NPI assigned

Nov 17, 2006

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 VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ssullivan1426910@direct.novanthealth.org

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.

• New Hanover Medical Group PA

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1992751374
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104990829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 CAMBRIDGE CRES",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235081255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOHN PAUL JONES CIRCLE",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082197",
            "telephone_number": "757-953-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Sublett, DO
• Suburban Pharmacy Inc
• Lucas Vincent Suder, MD
• Suffolk United, Inc
• Eric Francis Sulava
• Dylan Summers, PA-C
• Robert C Summers, AUD
• Sunny Steps Home Health Services LLC
• Sunrise Horizon Community & Health Solutions
• Sunrise Horizon Home Healthcare, LLC

• Pediatric Gastroenterology Physician in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Pediatric Gastroenterology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.