Active NPI
Brian C Sullivan, D.C.
- Chiropractor
- Boston, MA
National Provider Identifier
1336282961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHI2069
- Practice address
- 653 E Broadway
Boston, MA 02127-1554 - Phone
- (617) 464-0900
- Fax
- (617) 464-3434
- NPI assigned
- Feb 14, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHI2069 | MA | Primary |
Addresses
Primary practice location
653 E Broadway
Boston, MA 02127-1554
Mailing address
653 E Broadway
Boston, MA 02127-1554
Phone (617) 464-0900
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHI2069 | MA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sullivan Chiropractic & Rehabilitation, Inc. | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Beverly, MA
- NPI 1407031677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1336282961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 E BROADWAY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021271554",
"telephone_number": "617-464-0900",
"fax_number": "617-464-3434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 E BROADWAY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021271554",
"telephone_number": "617-464-0900",
"fax_number": "617-464-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRIAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "CHI2069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.