Mark Allan Sullivan, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2612 Issued in OH

Practice address

4196 Avery Rd
Hilliard, OH 43026-1004

Phone

(614) 876-1111

Fax

(614) 876-5600

NPI assigned

Dec 29, 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 OH

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• New-Life Chiropractic Inc.

  • Chiropractor
  • Hilliard, OH
  • NPI 1366610636
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689730863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4196 AVERY RD",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261004",
            "telephone_number": "614-876-1111",
            "fax_number": "614-876-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4196 AVERY RD",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261004",
            "telephone_number": "614-876-1111",
            "fax_number": "614-876-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "2612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195735",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia A Stuart, CNP
• Nicholas R. Styn, MD
• Megan Subr, DPT
• Erin Marie Sullivan, LPC
• Lori Ann Sullivan, M.D.
• Stephanie Summers, MS, CF-SLP
• Surgevity, LLC
• Mary Suszczynski, MSSA, LSW
• Tiffany Swain, FNP
• Autumn Lynn Swords, PTA

• Chiropractor in Hilliard, OH
• Providers in Hilliard, OH by specialty
• Chiropractor in Ohio

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.