Gary B Sullivan, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

30224 Issued in GA

Practice address

1523 Fair Rd
Statesboro, GA 30458-6025

Phone

(912) 871-2000

Fax

(912) 871-2500

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Creighton University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Statesboro OB-GYN Specialists, PCGroup PAC ID 0840181822, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gary.sullivan.1@8182.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8182/brand/1/csg/1/fhir/r4

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.

• Statesboro OB-GYN Specialists, PC

  • Specialist
  • Statesboro, GA
  • NPI 1841348521
  Medicare reassignment Care Compare group NPD
• The Women'S Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Statesboro, GA
  • NPI 1831301050
  Medicare reassignment NPD
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)

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

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1659334597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1958",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591958",
            "telephone_number": "912-871-2000",
            "fax_number": "912-871-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304586025",
            "telephone_number": "912-871-2000",
            "fax_number": "912-871-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "GARY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "30224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000353955C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Robert Stockton, CRNA
• Lindsey Stone, PHD
• Michael E Stoneking, P.H.D.
• Summer M Strickland, FNP
• Amber Stroud
• Sunbridge Statesboro Health Care Center, Inc.
• Superior Nursing Kare and Staffing LLC
• Supreme Internal Medicine
• Supreme Internal Medicine, P.C.
• Trina Suttles

• Specialist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.