Active NPI
Martin Anthony Sullivan, DC
- Nutrition Chiropractor
- Atlanta, GA
National Provider Identifier
1285192633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- CHIRO10176
- Practice address
- 4969 Roswell Rd Ste 100-105
Atlanta, GA 30342-2678 - Phone
- (404) 255-3110
- NPI assigned
- Mar 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | CHIRO10176 | GA | Primary |
Addresses
Primary practice location
4969 Roswell Rd Ste 100-105
Atlanta, GA 30342-2678
Mailing address
1295 Dresden Dr NE Unit 126
Brookhaven, GA 30319-3748
Phone (850) 598-1119
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 |
|---|---|---|---|
| CHIRO10176 | GA | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1285192633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1295 DRESDEN DR NE UNIT 126",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303193748",
"telephone_number": "850-598-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4969 ROSWELL RD STE 100-105",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303422678",
"telephone_number": "404-255-3110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MARTIN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "GA",
"license": "CHIRO10176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.