Christian James Sullivan, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

003724 Issued in TN

Practice address

235 Medical Park Blvd
Bristol, TN 37620

Phone

(423) 274-6350

Fax

(423) 274-6354

NPI assigned

Jul 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

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 2

Specialty

Gastroenterology

Education

Philadelphia College of Osteopathic Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gastroenterology AssociatesGroup PAC ID 4789781048, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
• Russell County Hospital Hospital, Lebanon, VA, CCN 490002
• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Gastroenterology Associates

  • Specialist
  • Kingsport, TN
  • NPI 1770578270
  Medicare reassignment Care Compare group NPD

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

• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation
• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation
• Mountain States Health Alliance

  dba Russell County Hospital

  • General Acute Care Hospital
  • Lebanon, VA
  • NPI 1891973939
  Care Compare affiliation

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

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1659669273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W RAVINE RD STE 3-A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603847",
            "telephone_number": "423-246-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-274-6350",
            "fax_number": "423-274-6354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6245 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481354001",
            "country_code": "US",
            "telephone_number": "734-421-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "616 Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242109706",
            "country_code": "US",
            "telephone_number": "423-274-6350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "235 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "37620",
            "country_code": "US",
            "telephone_number": "423-274-6350",
            "fax_number": "423-274-6354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTIAN",
        "middle_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-17",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019440",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "003724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Strategic Anesthesia Services LLC
• Malinda Maye Stuart, BS
• Jacinta Tamara Stumbo, MA
• Brett Stump
• Kimberly Sturgill, FNP
• Surgical Assoicates, P.C.
• Robert A Sutherland, CMSW
• Cassie Swayne, CNM
• Alexandria Sydnor
• Geoff S Szabo, NP

• Gastroenterology Physician in Bristol, TN
• Providers in Bristol, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.