Michael Douglas Sullivan, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2832 Issued in NC

Practice address

2315 W Arbors Dr Ste 208a
Charlotte, NC 28262-2577

Phone

(704) 547-1800

Fax

(704) 547-1611

NPI assigned

Sep 27, 2005

Last updated

Jun 29, 2021By the provider in NPPES

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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sullivan Family Chiropractic, P.a.

  • Chiropractor
  • Charlotte, NC
  • NPI 1740369982
  Medicare reassignment NPD Authorized official
• Payne Chiropractic Center PA

  • Chiropractor
  • Statesville, NC
  • NPI 1093765984
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1194711804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 W ARBORS DR STE 208A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622577",
            "telephone_number": "704-547-1800",
            "fax_number": "704-547-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 W ARBORS DR STE 208A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282622577",
            "telephone_number": "704-547-1800",
            "fax_number": "704-547-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0844X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "618994",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-INDIVIDUAL",
            "identifier": "7998160",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC/BCBS-GROUP",
            "identifier": "0194L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890844X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO-SULLIVAN FAMILY",
            "identifier": "3002130",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-SULLIVAN FAMILY CHI",
            "identifier": "7386420",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Marie Sullivan, CRNA
• Melanie Lee Dunn Sullivan, FNP-C
• Melissa Sullivan, PHARM.D.
• Melissa Evans Sullivan, NP
• Michael Daris Sullivan, NP
• Michelle Julie Sullivan, DNP
• Morgan Sullivan, PHARMD
• Rachel Louise Sullivan, DPT
• Robert Jackson Sullivan III, MSW, LCSWA
• Sarah Sullivan, LCMHC, NCC

• Chiropractor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.