NPIMap

Individual provider Active NPI

James Sullivan, MD

  • Internal Medicine Physician
  • Goldsboro, NC
National Provider Identifier
1164713756
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2016-00449 Issued in NC
Practice address
2700 Wayne Memorial Dr
Medical Education
Goldsboro, NC 27534-9494
Phone
(919) 736-1110
Fax
(315) 624-6469
NPI assigned
Apr 29, 2011
Last updated
Mar 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2016-00449 NC Primary
Hospitalist Physician 208M00000X 276980 NY

Addresses

Primary practice location

2700 Wayne Memorial Dr
Medical Education
Goldsboro, NC 27534-9494

Mailing address

2700 Wayne Memorial Dr
Medical Education
Goldsboro, NC 27534-9494

Other identifiers 1

IdentifierTypeStateIssuer
03914734MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160719000995 NC Practitioner - Family PracticePractitioner - Hospitalist 0941421887 Reassigns benefits to 3 organizations
I20170512001827 NV Practitioner - Hospitalist 0941421887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Hospitalists LLPGroup PAC ID 7214076322, 197 clinicians

Practice addresses (Care Compare)

7495 W Azure Dr
Suite 209
Las Vegas, NV 89130-4440
Phone (702) 407-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.17 of 100Reported as individual
Quality
60.24
Improvement activities
0
Cost
69.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2016-00449NCMDInternal Medicine Physician
276980NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients
Hospitalist Medicine Physicians of North Carolina PLLC Internal Medicine CurrentSince Apr 22, 2017 Accepting new patients
Moses Cone Physician Services Inc Hospitalist CurrentSince Feb 15, 2017 Accepting new patients
Platinum Hospitalists LLP Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Jun 5, 2017 Accepting new patients
Platinum Hospitalists LLP Internal Medicine CurrentSince May 1, 2017 Accepting new patients
Moses Cone Affiliated Physicians, Inc Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1200 N Elm St
Ste 5
Greensboro, NC 27401

10624 S Eastern Ave
#A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A955
Henderson, NV 89052
Phone (702) 407-7700

10624 S Eastern Ave
Ste A995
Henderson, NV 89052

7495 W Azure Dr
Ste 209
Las Vegas, NV 89130
Phone (702) 327-6653

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1164713756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "address_2": "MEDICAL EDUCATION",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "address_2": "MEDICAL EDUCATION",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494",
            "telephone_number": "919-736-1110",
            "fax_number": "315-624-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-29",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-00449",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "276980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03914734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.