DAVID JAMES SULLIVAN PA-C NPI 1245281088

NPI Information

  • NPI: 1245281088
  • Provider Name: DAVID JAMES SULLIVAN, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: CARILION MEMORIAL HOSPITAL
    BELLVIEW AND JEFFERSON STREETS
    RAONOKE, VA
    ZIP 24014
  • Phone: (540) 981-8250

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NPI Details

David James Sullivan, PA-C is a surgical physician assistant in Raonoke, VA. David James Sullivan, PA-C NPI is 1245281088. 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:

CARILION MEMORIAL HOSPITAL
BELLVIEW AND JEFFERSON STREETS
RAONOKE, VA
ZIP 24014
Phone: (540) 981-8250

The enumeration date for this NPI number is 5/15/2006 and was last updated on 10/27/2008.

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
1363AS0400XPhysician AssistantSurgical0110001586VIRGINIAYes

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
1017654C19MEDICARE PINVIRGINIA
21245281088MEDICAIDVIRGINIA

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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