James Fred Sullivan, RKT CEP

Primary specialty

KinesiotherapistTaxonomy code 226300000X

License

621 Issued in LA

Practice address

510 E Stoner Ave
Shreveport, LA 71101-4243

Phone

(318) 424-6106

Fax

(318) 429-5727

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649384983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HUNTER LEE LN",
            "city": "STONEWALL",
            "state": "LA",
            "postal_code": "710784800",
            "telephone_number": "318-925-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-424-6106",
            "fax_number": "318-429-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JAMES",
        "middle_name": "FRED",
        "name_prefix": "Mr.",
        "credential": "RKT  CEP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "LA",
            "license": "621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Sulaiman, M.D.
• Catherine Sullivan, MHP
• Chocka Sullivan, LCSW
• Felicia Sullivan, LPN
• Fred M Sullivan Jr., MD
• Michael J Sullivan, MD
• Miyoshi Umeakiiretta Sullivan
• Regina Galloway Sullivan
• Muhammad Junaid Sultan, MD
• Nazifa Sultana, AU. D.

• Kinesiotherapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Kinesiotherapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.