Farah Taj Sultan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24915 Issued in AL

Practice address

2018 Brookwood Medical Ctr Dr
Suite G-5 Professional Office BLDG
Birmingham, AL 35209-6898

Phone

(205) 877-2900

Fax

(205) 877-2904

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rejuvenation Wellness LLC

  • Family Medicine Physician
  • Homewood, AL
  • NPI 1619397247
  NPD (past) Authorized official

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750499596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CTR DR",
            "address_2": "SUITE G-5 PROFESSIONAL OFFICE BLDG",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096898",
            "telephone_number": "205-877-2900",
            "fax_number": "205-877-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 BROOKWOOD MEDICAL CTR DR",
            "address_2": "SUITE G-5 PROFESSIONAL OFFICE BLDG",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096898",
            "telephone_number": "205-877-2900",
            "fax_number": "205-877-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTAN",
        "first_name": "FARAH",
        "middle_name": "TAJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "24915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Janette Sullivan, CRNP
• Nicholas Cole Sullivan
• Paula Delane Sullivan, CRNP, BC
• Sharonda B Sullivan
• Tyler Briant Sullivan, MD
• Parvez K Sultan, MD
• David Summerlin
• Thanh Le Summerlin, M.D.
• Jesse Duncan Summers
• William D Summers, M.D.

• Family Medicine Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Family Medicine Physician in Alabama

• 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; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.