Sullivan Chiropractic Centers, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6121 Issued in TX

Legal business name

SULLIVAN CHIROPRACTIC CENTERS, PA

Doing business as

Sullivan Chiropractic Center

Practice address

428 Maplelawn Dr
Ste 100
Plano, TX 75075-5745

Phone

(972) 612-7880

Fax

(469) 429-2929

NPI assigned

May 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sandra Jane Sullivan, D.C.NPI 1457468241

Title

President

Phone

(972) 612-7880

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sullivan Chiropractic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Sullivan Chiropractic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sullivan Chiropractic Centers, P.a.

  dba Sullivan Chiropractic Center

  • Chiropractor
  • Mesquite, TX
  • NPI 1366691123
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Jane Sullivan, DC

  • Chiropractor
  • Mesquite, TX
  • NPI 1457468241
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1548437452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 MAPLELAWN DR",
            "address_2": "STE100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755745",
            "telephone_number": "972-612-7880",
            "fax_number": "469-429-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 MAPLELAWN DR",
            "address_2": "STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755745",
            "telephone_number": "972-612-7880",
            "fax_number": "469-429-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN CHIROPRACTIC CENTERS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-612-7880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4855884",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ye Joon Suh, D.D.S.
• Olga Tabakman Sukenik, O.D.
• Adebola Sulaiman
• Suraj Sulhan, MD
• Lee Mary Sulkin, NP
• Erin Sullivan-Baca, PHD
• Adriana Sullivan
• Anne Sullivan
• John Perry Sullivan, MD
• Timothy Sullivan, M.D.

• Chiropractor in Plano, TX
• Providers in Plano, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.