Active NPI
Patrick Sullivan
- Clinic/Center
- Hudson, FL
National Provider Identifier
1932556685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 10115
- Practice address
- 7211 Beacon Woods Dr
Hudson, FL 34667-1975 - Phone
- (727) 967-8657
- NPI assigned
- May 23, 2016
- Last updated
- May 23, 2016
- 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 |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 10115 | FL | Primary |
Addresses
Primary practice location
7211 Beacon Woods Dr
Hudson, FL 34667-1975
Mailing address
7211 Beacon Woods Dr
Hudson, FL 34667-1975
Phone (727) 967-8657
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10115 | FL | MD | General Practice Dentistry |
Organizations & group practices 1
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.
-
- Assisted Living Facility
- Hudson, FL
- NPI 1497157754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463961600000",
"number": "1932556685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7211 BEACON WOODS DR",
"city": "HUDSON",
"state": "FL",
"postal_code": "346671975",
"telephone_number": "727-967-8657",
"fax_number": "727-857-5928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7211 BEACON WOODS DR",
"city": "HUDSON",
"state": "FL",
"postal_code": "346671975",
"telephone_number": "727-967-8657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "PATRICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-23",
"last_updated": "2016-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "FL",
"license": "10115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.