Patrick Benjamin Sullivan

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2255A2300 Issued in VA

Practice address

724 Sanhill Dr
Lynchburg, VA 24502-4924

Phone

(540) 290-7502

NPI assigned

Oct 7, 2016

Last updated

Oct 7, 2016By the provider in NPPES

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": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1881144384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 SANHILL DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024924",
            "telephone_number": "540-290-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 SANHILL DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024924",
            "telephone_number": "540-290-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PATRICK",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "2255A2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lee Stutesman, MD
• Elizabeth Marie Suarez, LPC
• Benjamin Suhl
• Albert Sul, CMT
• Daniel J. Sullivan, LPC
• Robert A Sullivan Jr., MD
• Sarah Sullivan, PT
• Stephanie K Sullivan, MD
• Michael Roy Sumfest
• Heather Marie Summers

• Athletic Trainer in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.