Individual provider Active NPI

Lori Ann Sullivan, M.D.

  • Family Medicine Physician
  • Hilliard, OH
National Provider Identifier
1417028697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
054044 Issued in OH
Practice address
3617 Heritage Club Dr
Hilliard, OH 43026-1313
Phone
(614) 777-5530
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 054044 OH Primary

Addresses

Primary practice location

3617 Heritage Club Dr
Hilliard, OH 43026-1313

Mailing address

3617 Heritage Club Dr
Hilliard, OH 43026-1313
Phone (614) 777-5530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090527000388 OH Practitioner - Family Practice 9739113648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

55 N High St
New Albany, OH 43054-7099
Phone (614) 627-1878

Hospital & facility affiliations

  • Mount Carmel Home Care Home health agency, Columbus, OH, CCN 367273
  • Ohiohealth Home Health With Compassus Home health agency, Dublin, OH, CCN 367615
  • Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Doctors Hospital Hospital, Columbus, OH, CCN 360152
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054044OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lori a Sullivan MD LLC Family Medicine Current Accepting new patients
Mount Carmel Healthproviders Inc Family Medicine CurrentSince Nov 1, 2010 Accepting new patients
Mount Carmel Health Providers Inc Family Medicine CurrentSince Nov 1, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

4674 Britton Pkwy
Ste 2200
Hilliard, OH 43026
Phone (614) 210-4555

3617 Heritage Club Dr
Hilliard, OH 43026
Phone (614) 234-9777

55 N High St
New Albany, OH 43054
Phone (614) 627-1878

Interoperability endpoints

  • Direct secure messaging: lsullivan1147845@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417028697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 HERITAGE CLUB DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261313",
            "telephone_number": "614-777-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 HERITAGE CLUB DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261313",
            "telephone_number": "614-777-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "054044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilliard, OH

Sources for this page

Verify at the official NPI Registry.