Active NPI
Brian Sullivan, PHARM.D.
- Pharmacist
- Pittsburg, KS
National Provider Identifier
1699945709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12499
- Practice address
- 909 E Centennial Dr
Pittsburg, KS 66762-6601 - Phone
- (620) 231-8130
- Fax
- (620) 231-0524
- NPI assigned
- Mar 4, 2008
- Last updated
- Mar 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12499 | KS | Primary |
Addresses
Primary practice location
909 E Centennial Dr
Pittsburg, KS 66762-6601
Mailing address
909 E Centennial Dr
Pittsburg, KS 66762-6601
Phone (620) 231-8130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12499 | Other | KS | KS BOARD OF PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12499 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1699945709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 E CENTENNIAL DR",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667626601",
"telephone_number": "620-231-8130",
"fax_number": "620-231-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 E CENTENNIAL DR",
"city": "PITTSBURG",
"state": "KS",
"postal_code": "667626601",
"telephone_number": "620-231-8130",
"fax_number": "620-231-0524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-04",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "12499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KS BOARD OF PHARMACY",
"identifier": "12499",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburg, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.