Timothy M Sullivan, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

9900691 Issued in NC

Practice address

1900 Randolph Rd
Ste 900
Charlotte, NC 28207-1122

Phone

(704) 377-2424

Fax

(704) 377-2687

NPI assigned

Jul 14, 2006

Last updated

Jan 11, 2010By the provider in NPPES

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Cincinnati College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment Care Compare group NPD
• Patheous Medical PLLC

  • Diagnostic Radiology Physician
  • Leawood, KS
  • NPI 1366121527

  NC

  Medicare reassignment NPD
• Emergency Medicine Physicians of Iredell County, PLLC

  • Emergency Medicine Physician
  • Statesville, NC
  • NPI 1104151109
  NPD (past)
• Emergency Medicine Physicians of Mecklenburg County, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1912232182
  NPD (past)
• Internal Medicine Specialist, PA

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1326079567
  NPD (past)
• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  NPD (past)
• Linville Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Linville, NC
  • NPI 1962656157
  NPD (past)
• Mid-Atlantic Emergency Medical Associates, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1073562757
  NPD (past)
• North Carolina Emergency Partners LLC

  • Emergency Medicine Physician
  • Statesville, NC
  • NPI 1730405093
  NPD (past)
• Piedmont Emergency Medical Associates, PA

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1801822523
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catawba Valley Medical Center

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1164495255
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1760408967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "STE 900",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071122",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD",
            "address_2": "STE 900",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071122",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9900691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891225H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00692",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Louise Sullivan, DPT
• Robert Jackson Sullivan III, MSW, LCSWA
• Sarah Sullivan, LCMHC, NCC
• Sarah Sullivan, PT, DPT
• Sharon B. Sullivan, MD
• Samantha Setzer Sult, LPCA
• Faye E. Sultan, PH.D.
• Dominic Anthony Sultana
• Andrew Ivan Sumich, MD
• Ariesha Shawnte Sumlar-Davis

• Emergency Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.