Active NPI
Charles Curtis Sullivan, MD, MBA
- Family Medicine Physician
- Spring Hill, FL
National Provider Identifier
1821069923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME88431
- Practice address
- 120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220 - Phone
- (352) 688-2118
- Fax
- (352) 688-3118
- NPI assigned
- Jan 28, 2006
- Last updated
- Nov 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME88431 | FL | Primary |
Addresses
Primary practice location
120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220
Mailing address
120 Medical Blvd
Suite 108
Spring Hill, FL 34609-0220
Phone (352) 688-2118
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BCBS37656 | Other | BCBS | |
| FIRST HEALTH 2160822 | Other | FIRST HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Spring Hill, FL
- NPI 1265644876
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1821069923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 MEDICAL BLVD",
"address_2": "SUITE 108",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346090220",
"telephone_number": "352-688-2118",
"fax_number": "352-688-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MEDICAL BLVD",
"address_2": "SUITE 108",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346090220",
"telephone_number": "352-688-2118",
"fax_number": "352-688-3118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CHARLES",
"middle_name": "CURTIS",
"name_prefix": "Dr.",
"credential": "MD, MBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-28",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME88431",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "BCBS37656",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "FIRST HEALTH 2160822",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Spring Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.