Michael Stanley Sullivan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2022-01788 Issued in NC

Practice address

2636 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4238

Phone

(252) 636-1919

Fax

(252) 636-2656

NPI assigned

Apr 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msullivan19474@carolinaeastmc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carolinaeast Physicians

  • Cardiovascular Disease Physician
  • New Bern, NC
  • NPI 1104066794

  Pediatrics

  Medicare reassignment NPD
• Carolinaeast Physicians

  • Pediatrics Physician
  • New Bern, NC
  • NPI 1235430976
  NPD
• Carolinaeast Physicians

  • Obstetrics & Gynecology Physician
  • New Bern, NC
  • NPI 1619868981
  NPD
• Carolinaeast Physicians

  • Internal Medicine Physician
  • Pollocksville, NC
  • NPI 1255632006

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1265495659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "POLLOCKSVILLE",
            "state": "NC",
            "postal_code": "285730068",
            "telephone_number": "252-636-1919",
            "fax_number": "252-636-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624238",
            "telephone_number": "252-636-1919",
            "fax_number": "252-636-2656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Pinckney Blvd",
            "address_2": "Naval Hospital Beaufort",
            "address_purpose": "LOCATION",
            "city": "Beaufort",
            "state": "SC",
            "postal_code": "299026148",
            "country_code": "US",
            "telephone_number": "843-228-5577",
            "fax_number": "843-228-5196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2022-09-12",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2022-01788",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD09704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona Strong
• Breta Joy Stroud, LMBT, BCSI, MMP
• Molly C Stuelke
• Alec Styer
• Abigail Suggs
• Charles Summerlin
• Supreme Investments,LLC
• Amy Sutter
• Sandra K Sutton, MA CCC-SLP
• Robert T. Swadling, CP, CDA, BOCO

• Pediatrics Physician in New Bern, NC
• Providers in New Bern, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.