Khalfani Sullivan, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001450-1 Issued in NY

Practice address

102 Irving St NW
Washington, DC 20010-2921

Phone

(202) 877-1000

NPI assigned

Nov 5, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1871966317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 GOODWIN ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207842521",
            "telephone_number": "202-689-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102921",
            "telephone_number": "202-877-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KHALFANI",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001450-1",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL2581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sullivan, NP
• Ginger McKelvey Sullivan, MA, LPC, CGP, FAGPA
• Jacob Sullivan, MD
• Jamie Sullivan
• June Marie Sullivan, PA
• Kira H Sullivan, PT
• Kirby Marie Sullivan, MD
• La'Tonya V Sullivan
• Laura Sullivan, RD
• Malgorzata Jolanta Sullivan, MD

• Athletic Trainer in Washington, DC
• Providers in Washington, DC by specialty
• Athletic Trainer in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.