Paul J. Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA003014L Issued in PA

Practice address

36000 Darnall Loop, Room 1272
Carl R. Darnall Army Medical Center
Ft Hood, TX 76544

Phone

(254) 288-8090

NPI assigned

Sep 12, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Allegheny Neurosurgery & Spine Associates, P.C.

  • Specialist
  • Pittsburgh, PA
  • NPI 1851348676
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1184728875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAKE RD",
            "address_2": "APT 201",
            "city": "BELTON",
            "state": "TX",
            "postal_code": "765131524",
            "telephone_number": "724-953-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP, ROOM 1272",
            "address_2": "CARL R. DARNALL ARMY MEDICAL CENTER",
            "city": "FT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PAUL",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003014L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Jerome Strommen, M.D.
• Jennifer Rae Styles, PHARMD, RPH
• Lydia Y Suh
• Tenny Sherry Sulaiman, CRNA
• Lisa J Sullivan, PHARM.D.
• Sichang Sung
• Loree Kimberly Sutton, M.D.
• Nathaneal Swanson, PA-C
• David A Szink, DO
• Brian Matthew Tack

• Physician Assistant in Ft Hood, TX
• Providers in Ft Hood, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.