Brendan L Sullivan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101227543 Issued in VA

Practice address

9010 Lorton Station Blvd
Suite 100
Lorton, VA 22079-4792

Phone

(703) 436-1200

Fax

(703) 642-0392

NPI assigned

Mar 18, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: brendan.sullivan@allp.eclinicaldirectplus.com

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.

• Alexandria Lake Ridge Pediatrics

  • Pediatrics Physician
  • Alexandria, VA
  • NPI 1649215955
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1780643908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N BEAUREGARD ST",
            "address_2": "SUITE 200",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111723",
            "telephone_number": "703-436-1200",
            "fax_number": "703-575-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 LORTON STATION BLVD",
            "address_2": "SUITE 100",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794792",
            "telephone_number": "703-436-1200",
            "fax_number": "703-642-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRENDAN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101227543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6721001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stars4Ucollection Inc
• Amanda Lynn Stathos, MS, RD, LD
• Jessica Steinman
• Alison Stern, M.ED.
• Stephen Van Dorn Stone, MD
• Surgical Specialists of Northern Virginia
• Rebecca Elizabeth Sutter, APRN FNP
• Bridget Haley Sykes
• Moussa Sylla, DC
• John Sante Symington, M.D.

• Pediatrics Physician in Lorton, VA
• Providers in Lorton, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.