Individual provider Active NPI

Christopher Charles Sullivan, MD

  • Pediatrics Physician
  • Marshfield, MA
National Provider Identifier
1235374638
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
261703 Issued in MA
Practice address
435 Furnace St
Marshfield, MA 02050-2328
Phone
(781) 837-7200
Fax
(781) 837-7255
NPI assigned
Dec 13, 2008
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 261703 MA Primary

Addresses

Primary practice location

435 Furnace St
Marshfield, MA 02050-2328

Mailing address

PO Box 68
S Weymouth, MA 02190-0001
Phone (780) 803-2786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925002613 MA Practitioner - Pediatric Medicine 3476827700 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261703MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare South PC Pediatrics CurrentSince Aug 15, 2017 Accepting new patients

Locations

435 Furnace St
Marshfield, MA 02050
Phone (781) 834-4234

56 New Driftway
Ste 301
Scituate, MA 02066
Phone (781) 383-6261

Interoperability endpoints

  • Direct secure messaging: christophersullivan@hcs.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1229126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1235374638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "S WEYMOUTH",
            "state": "MA",
            "postal_code": "021900001",
            "telephone_number": "780-803-2786",
            "fax_number": "781-812-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 FURNACE ST",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502328",
            "telephone_number": "781-837-7200",
            "fax_number": "781-837-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-13",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "261703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, MA

Sources for this page

Verify at the official NPI Registry.