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Individual provider Active NPI

Shelby A Sullivan, MD

  • Gastroenterology Physician
  • Lebanon, NH
National Provider Identifier
1851503999
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
32061 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-0001
Phone
(603) 650-5000
NPI assigned
May 3, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 32061 NH Primary
Gastroenterology Physician 207RG0100X 2007006900 MO

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-0001

Mailing address

PO Box 810
Hanover, NH 03755-0810

Other practice location 1

1635 Aurora Ct
Aurora, CO 80045-2541
Phone (720) 848-2775

Other identifiers 1

IdentifierTypeStateIssuer
968790183MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161015000168 CO Practitioner - GastroenterologyPractitioner - Internal Medicine 4688772478 Reassigns benefits to 1 organization
I20240624003611 NH Practitioner - Gastroenterology 4688772478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Washington University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy94
Upper gastrointestinal (GI) endoscopy for acid reflux124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Jun 17, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 22, 2016 Accepting new patients
Dartmouth-Hitchcock Clinic Gastroenterology CurrentSince Jun 17, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 17, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 22, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 17, 2024 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1851503999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037550810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 Aurora Ct",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452541",
            "country_code": "US",
            "telephone_number": "720-848-2775",
            "fax_number": "720-848-2757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHELBY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2026-09-29",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NH",
            "license": "32061",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "2007006900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "968790183",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.