Thomas James Sullivan Jr., MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

14879 Issued in SC

Practice address

100 Perpetual SQ
Anderson, SC 29621-1713

Phone

(864) 261-7474

Fax

(864) 261-8580

NPI assigned

May 26, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1117065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1225031966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PERPETUAL SQ",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211713",
            "telephone_number": "864-261-7474",
            "fax_number": "864-261-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PERPETUAL SQ",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211713",
            "telephone_number": "864-261-7474",
            "fax_number": "864-261-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "THOMAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-26",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "14879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612257D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148799",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iris Scott Suber, MCD-CCC-SLP
• Subha Parchuri, MD, PA
• Catherine Ray Sullivan, MPT
• Kayla Sullivan
• Kiara Sullivan
• Kevin Matthew Summers, D.O.
• Summit Home Health Care Inc.
• Summit Home Health Care, Inc
• Lewis Tyler Sumner, D.M.D.
• Ja'Pel Sumpter

• Cardiovascular Disease Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Cardiovascular Disease Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.