NPIMap

Organization Active NPI

Scot a Sullivan MD PC

  • Medical Specialty Clinic/Center
  • Edmond, OK
National Provider Identifier
1831610641
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
20157 Issued in OK
Legal business name
SCOT A SULLIVAN MD PC
Practice address
2020 E 15TH St Ste B
Edmond, OK 73013-6749
Phone
(405) 348-9993
NPI assigned
Jun 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Authorized official

Name
Dr. Scot Sullivan, MDNPI 1164481230
Title
Owner
Phone
(503) 841-7593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 20157 OK Primary

Addresses

Primary practice location

2020 E 15TH St Ste B
Edmond, OK 73013-6749

Mailing address

1025 NW Couch St Unit 819
Portland, OR 97209-4132
Phone (503) 841-7593

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1831610641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 NW COUCH ST UNIT 819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094132",
            "telephone_number": "503-841-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 15TH ST STE B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136749",
            "telephone_number": "405-348-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOT A SULLIVAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "SCOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-841-7593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "20157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.