Daniel Joseph Sullivan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NC1778 Issued in NC

Practice address

1180 Blowing Rock Rd
Suite 1a
Boone, NC 28607-4883

Phone

(828) 264-2020

Fax

(828) 264-8918

NPI assigned

Jun 6, 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 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

William C Henson OD PAGroup PAC ID 0749439941, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• William C Henson OD PA

  • Optometrist
  • Boone, NC
  • NPI 1104176882

  NC, Optometrist

  Medicare reassignment Care Compare group NPD
• Jillian Iris Okeefe OD PA

  • Optometrist
  • Greensboro, NC
  • NPI 1629636402
  NPD (past)
• Winston Salem Optometric Group PA

  • Optometrist
  • Winston Salem, NC
  • NPI 1457511586
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1750320404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BLOWING ROCK RD",
            "address_2": "SUITE 1A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074883",
            "telephone_number": "828-264-2020",
            "fax_number": "828-264-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BLOWING ROCK RD",
            "address_2": "SUITE 1A",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074883",
            "telephone_number": "828-264-2020",
            "fax_number": "828-264-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "0919I",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790919I",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita F Stroupe, LCSW
• Sherida Ann Stroyek, OTRL
• Cassandra Lynn Stull, MPAS, PA-C
• Kyler Bridgeman Sudhoff
• Andrew Sufficool, ATC,LAT
• Margaret Christine-Marie Sullivan
• Rebecca A Summerford, LPT
• Jamie D Summerlin
• Brett Summey Jr., M.D.
• Rodney Sumner

• Optometrist in Boone, NC
• Providers in Boone, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.