Donald J Sullivan MD

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

DONALD J SULLIVAN MD

Practice address

9636 Fox Hill Cir N
Germantown, TN 38139-6810

Phone

(901) 315-7932

NPI assigned

Mar 2, 2009

Reactivated

Mar 3, 2011

Last updated

Apr 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald J Sullivan, MDNPI 1508814484

Title

Sole Owner

Phone

(901) 213-5460

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald J Sullivan, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Germantown, TN
  • NPI 1508814484
  Medicare reassignment NPD Authorized official
• Amber Elizabeth Adams, NP

  • Adult Health Nurse Practitioner
  • Memphis, TN
  • NPI 1053791616
  Medicare reassignment NPD
• Barbara Dennis, NP-C

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1831584622
  Medicare reassignment NPD
• Dorinda Jones

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1598075558
  Medicare reassignment NPD

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1124268297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 0194",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480194",
            "telephone_number": "901-315-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9636 FOX HILL CIR N",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396810",
            "telephone_number": "901-315-7932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Austin Peay Hwy",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381282502",
            "country_code": "US",
            "telephone_number": "901-213-5460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3960 New Covington Pike",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381282504",
            "country_code": "US",
            "telephone_number": "901-315-7932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7691 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381383904",
            "country_code": "US",
            "telephone_number": "901-315-7932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DONALD J SULLIVAN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "deactivation_date": "2009-05-04",
        "reactivation_date": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "901-213-5460",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522858",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Richard Dismukes, MD
• Mallory McGoff Dixon, DNP FNP-C
• Telisha Dixon, FNP
• Christian Dodd, PHARMD
• Elizabeth M. Domico, MS, CCC/A
• Heather O Donato, M.D.
• Francis Daniel Donovan Jr., MD
• William Dorsey
• Michella Glenna Douglas, PA-C
• Paul Michael Douthitt, M.D.

• Pain Medicine Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Pain Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.