Gsa Plano

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8483 Issued in TX

Legal business name

GSA PLANO

Practice address

6101 Windcom CT
Ste 300
Plano, TX 75093-7895

Phone

(972) 378-9991

Fax

(972) 378-9992

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy E Sullivan, D.O.

Title

Doctor

Phone

(972) 378-9991

Specialties & licenses 1

Addresses

Other names 1

• Genesis Spine Associates Other name

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184843245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 WINDCOM CT STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937895",
            "telephone_number": "972-378-9991",
            "fax_number": "972-378-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 WINDCOM CT",
            "address_2": "STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750937895",
            "telephone_number": "972-378-9991",
            "fax_number": "972-378-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GSA PLANO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "972-378-9991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Spine Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gary Alan Grossman, PH.D
• Barbara Ann Groussman, PH.D
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• Michelle Grundstrom, MD
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• Guardian Neuromonitoring, PLLC
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• Guardian Recovery Dallas Addiction Center, LLC

• Chiropractor in Plano, TX
• Providers in Plano, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.