Julie Gail Sullivan, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

23824 Issued in OK

Practice address

1615 S Eucalyptus Ave
Suite 210
Broken Arrow, OK 74012-6159

Phone

(918) 254-6822

Fax

(918) 254-6823

NPI assigned

Jun 20, 2005

Last updated

Jan 24, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Pointe Pediatrics, PLLC

  • Pediatric Adolescent Medicine Physician
  • Broken Arrow, OK
  • NPI 1235399122
  NPD (past) Authorized official
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1578568010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 S EUCALYPTUS AVE",
            "address_2": "SUITE 210",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126159",
            "telephone_number": "918-254-6822",
            "fax_number": "918-254-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 S EUCALYPTUS AVE",
            "address_2": "SUITE 210",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740126159",
            "telephone_number": "918-254-6822",
            "fax_number": "918-254-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JULIE",
        "middle_name": "GAIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OK",
            "license": "23824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah A Stumbo, PT
• Addison Grace Sturgeon
• Taylor Marie Sturtevant
• Sui Generis Counseling and Life Care Services, PLLC
• Christopher James Sullivan, PHARMD
• Rhonda S Sullivan, RN, ANCLC
• Karen Jean Sumpter, MS, CCC-SLP
• Amber Sund
• Sundene Internal Medicine, PLLC
• Sunshine Smiles PLLC

• Pediatric Adolescent Medicine Physician in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Pediatric Adolescent Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.