GARY J SULLIVAN DC
NPI 1104808385
Chiropractor in Roxboro, NC
About Gary J Sullivan Dc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GARY J SULLIVAN DC (NPI 1104808385) is a healthcare organization registered as a chiropractor in Roxboro, North Carolina and active in the NPI registry since November 2005. The organization lists Gary J Sullivan, Gen Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gary J Sullivan Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Gary J Sullivan Dc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sullivan Chiropractic Clinic's NPI number?
The NPI number for Sullivan Chiropractic Clinic is 1104808385. It was assigned to this organization in the NPPES registry on November 15, 2005. The provider is also known as Gary J Sullivan Dc.
Where is Sullivan Chiropractic Clinic located?
Sullivan Chiropractic Clinic is located at 30 Semora Rd, Roxboro, NC 27573. The listed phone number is (336) 599-6771.
What is Sullivan Chiropractic Clinic's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Sullivan Chiropractic Clinic enrolled in Medicare?
Yes. Sullivan Chiropractic Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sullivan Chiropractic Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Sullivan Chiropractic Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Sullivan Chiropractic Clinic was last updated on August 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gary J Sullivan Dc · NPI 1104808385
Chiropractor organization in Roxboro, North Carolina. Organization record, active in the CMS NPPES registry since November 15, 2005.
## Identity
- **NPI:** 1104808385 (Entity type: Organization)
- **Enumerated:** November 15, 2005
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Legal business name:** Sullivan Chiropractic Clinic
- **Organization subpart:** No
- **Authorized official:** Gary Sullivan, GEN PARTNER
## Practice location
- **Address:** 30 SEMORA RD, Roxboro, NC 27573-6201
- **Phone:** (336) 599-6771 · **Fax:** (336) 599-6494
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 29, 2007
- **Other identifiers:** Medicare PIN 2447959 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1104808385) · Data from the CMS NPPES public registry.