SHANE SULLIVAN NPI 1184339699

NPI Information

  • NPI: 1184339699
  • Provider Name: SHANE SULLIVAN
  • Classification: Physical Medicine & Rehabilitation - 2081S0010X
  • Specialization: Sports Medicine
  • Entity Type: Individual
  • Address: 4221 GARRETT RD
    DURHAM, NC
    ZIP 27707
  • Phone: (919) 937-9607

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NPI Details

Shane Sullivan is a sports medicine physical medicine rehabilitation in Durham, NC. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. Shane Sullivan NPI is 1184339699. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4221 GARRETT RD
DURHAM, NC
ZIP 27707-467
Phone: (919) 937-9607

The enumeration date for this NPI number is 1/18/2023 and was last updated on 1/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12081S0010XPhysical Medicine & RehabilitationSports MedicineP21873NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NAOTHERNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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