NPIMap

Individual provider Active NPI

Cary Patrick Sullivan, D.O.

  • Family Medicine Physician
  • Vian, OK
National Provider Identifier
1497701130
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2148 Issued in OK
Practice address
128 W Main
Vian, OK 74962-0446
Phone
(918) 773-5228
Fax
(918) 289-2678
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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 2148 OK Primary

Addresses

Primary practice location

128 W Main
Vian, OK 74962-0446

Mailing address

PO Box 446
Vian, OK 74962-0446
Phone (918) 773-5228

Other identifiers 3

IdentifierTypeStateIssuer
731153208003OtherOKBLUE CROSS BLUE SHIELD
100254810EMedicaidOK
100254810GMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060614000309 OK Practitioner - Family Practice 4688686637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triton Health PLLCGroup PAC ID 1951623214, 2 clinicians
Triton Health Elder Care LLCGroup PAC ID 4082154927, 2 clinicians

Practice addresses (Care Compare)

128 W Main
Vian, OK 74962-1009
Phone (918) 773-5228

305 N Thornton St
Vian, OK 74962-5088
Phone (818) 773-5228

Hospital & facility affiliations

  • Professional Home Health Home health agency, Sallisaw, OK, CCN 377588
  • Cohesive Healthcare Home health agency, Shawnee, OK, CCN 377781
  • Enhabit Home Health of Eastern Oklahoma Home health agency, Muskogee, OK, CCN 377643
  • Premier Home Health Care, Inc Home health agency, Muldrow, OK, CCN 377706
  • Elara Caring XI Hospice, Sallisaw, OK, CCN 371560
  • Sequoyah County-City of Sallisaw Hospital Authorit Hospital, Sallisaw, OK, CCN 370112
  • Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062
  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055
  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
  • Northeastern Health System Hospital, Tahlequah, OK, CCN 370089
  • Vian Nursing & Rehab, LLC Nursing home, Vian, OK, CCN 375433

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions22
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2148OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Triton Health Elder Care LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
C. Patrick Sullivan,DO Family Medicine CurrentSince Jan 1, 1990 Accepting new patients
Vian Nursing & Rehab LLC Past Accepting new patients
Sequoyah County City of Sallisaw Hospital Authority Past Accepting new patients
Philip B Bovell, Mdpa Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: admin@cpsullivan.e-mdsdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vian Nursing & RehabVian, OK, CCN 375433 Skilled nursing facility Adp of the SNF Dec 8, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1497701130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "VIAN",
            "state": "OK",
            "postal_code": "749620446",
            "telephone_number": "918-773-5228",
            "fax_number": "918-773-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W MAIN",
            "city": "VIAN",
            "state": "OK",
            "postal_code": "749620446",
            "telephone_number": "918-773-5228",
            "fax_number": "918-289-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CARY",
        "middle_name": "PATRICK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "731153208003",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100254810E",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100254810G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vian, OK

Sources for this page

Verify at the official NPI Registry.