Active NPI
Brian Sullivan, MD, MHS
- Gastroenterology Physician
- Durham, NC
National Provider Identifier
1467794735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 2017-02118
- Practice address
- 508 Fulton St
Durham, NC 27705-3875 - Phone
- (919) 286-0411
- NPI assigned
- Mar 25, 2013
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 2017-02118 | NC | Primary |
Addresses
Primary practice location
508 Fulton St
Durham, NC 27705-3875
Mailing address
2301 Erwin Rd
Durham, NC 27705-4699
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017-02118 | NC | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1467794735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277054699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 FULTON ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277053875",
"telephone_number": "919-286-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRIAN",
"credential": "MD, MHS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-25",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "2017-02118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.