Active NPI
John Patrick Sullivan Jr., PSY.D.
- Clinical Psychologist
- Newport, RI
National Provider Identifier
1225368145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS00871
- Practice address
- 8 Bradford Ave
Newport, RI 02840-2202 - Phone
- (401) 258-6754
- NPI assigned
- Dec 29, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS00871 | RI | Primary |
| Exercise & Sports Psychologist | 103TE1100X | PS00871 | RI |
Addresses
Primary practice location
8 Bradford Ave
Newport, RI 02840-2202
Mailing address
8 Bradford Ave
Newport, RI 02840-2202
Phone (401) 258-6754
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS00871 | RI | MD | Exercise & Sports Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262044800000",
"number": "1225368145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 BRADFORD AVE",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028402202",
"telephone_number": "401-258-6754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 BRADFORD AVE",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028402202",
"telephone_number": "401-258-6754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JOHN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-12-29",
"last_updated": "2009-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS00871",
"primary": true
},
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": "RI",
"license": "PS00871",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.