Daniel Joseph Sullivan, M.D.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

35063476S Issued in OH

Practice address

1739 Beverly Ave
Suite 107
Kingman, AZ 86409-3593

Phone

(928) 681-8565

Fax

(928) 681-8564

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9045/brand/1/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 and National Provider Directory roles.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Robert L Kalb MD Inc

  • Orthopaedic Surgery Physician
  • Toledo, OH
  • NPI 1568656627
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1801895834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 BEVERLY AVE",
            "address_2": "SUITE 107",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8565",
            "fax_number": "928-681-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 BEVERLY AVE",
            "address_2": "SUITE 107",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8565",
            "fax_number": "928-681-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "35063476S",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "AZ",
            "license": "38140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321301",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taryn Strong
• Lund Leo Stucki, AUDIOPROSTHOLOGIST B
• Karen Stump
• Daniela Suarez, DO
• Mohammad Abdul Subhan, M.D.
• Jerry L Sullivan, DDS
• Katie Sumpter, MD
• Sunshine Assisted Living
• Ryan E Swapp, MD
• Jenni L Swenson, LPC, ATR-BC

• Orthopaedic Surgery of the Spine Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Orthopaedic Surgery of the Spine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.