MEDICARE: DR-DO-OMM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204D00000X	Neuromusculoskeletal Medicine & OMM Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558067538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR-DO-OMM

Provider Business Mailing Address
First Line	:	17 NEW SOUTH DR
Second Line	:
City	:	AMHERST
State	:	NH
Zip	:	03031-1606
Country	:	US
Telephone Number	:	603-759-1575
Fax Number	:

Provider Business Practice Location Address
First Line	:	292 ROUTE 101 UNIT F-1
Second Line	:
City	:	AMHERST
State	:	NH
Zip	:	03031-1730
Country	:	US
Telephone Number	:	603-341-9144
Fax Number	:	949-864-3717

Authorized Official
Title or Position	:	PHYSICIAN/ OWNER
Name	:	DR. JAMES C SULLIVAN
Credential	:	DO
Telephone Number	:	603-341-9144

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	09/17/2025

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Directions to “DR-DO-OMM ” Practice Location

Language	Start Address	Practice Location

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