Individual provider Active NPI

John Patrick Sullivan, MD

  • Anesthesiology Physician
  • Norman, OK
National Provider Identifier
1669571568
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
14800 Issued in OK
Practice address
419 W Gray St
Norman, OK 73069-7117
Phone
(405) 329-7300
Fax
(405) 364-5379
NPI assigned
Sep 21, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 14800 OK Primary

Addresses

Primary practice location

419 W Gray St
Norman, OK 73069-7117

Mailing address

419 W Gray St
Norman, OK 73069-7117
Phone (405) 329-7300

Other identifiers 2

IdentifierTypeStateIssuer
100824410AMedicaidOK
100824410BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20051008000068 OK Practitioner - AnesthesiologyPractitioner - Pain Management 4688604705 Practice locations: Norman, OK; Moore, OK

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Oklahoma College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3121 S Telephone Rd
Physicians Surgery
Moore, OK 73160-2944
Phone (405) 364-9789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1669571568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 W GRAY ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730697117",
            "telephone_number": "405-329-7300",
            "fax_number": "405-364-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W GRAY ST",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730697117",
            "telephone_number": "405-329-7300",
            "fax_number": "405-364-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2026-09-29",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "14800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100824410A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100824410B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.