Sullivan Family Practice, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SULLIVAN FAMILY PRACTICE, INC.

Practice address

3511 Old Clarksville Pike
Joelton, TN 37080-8892

Phone

(615) 299-5341

NPI assigned

Jul 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth W Sullivan, M.D.NPI 1376637215

Title

Owner

Phone

(615) 299-5341

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth W Sullivan, M.D.

  • Family Medicine Physician
  • Joelton, TN
  • NPI 1376637215
  NPD Authorized official

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1679914683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 OLD CLARKSVILLE PIKE",
            "city": "JOELTON",
            "state": "TN",
            "postal_code": "370808892",
            "telephone_number": "615-299-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 OLD CLARKSVILLE PIKE",
            "city": "JOELTON",
            "state": "TN",
            "postal_code": "370808892",
            "telephone_number": "615-299-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-299-5341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Joelton, TN
• Providers in Joelton, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.