Keri J Sullivan, RN, MS, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

252927 Issued in MA

Practice address

300 Longwood Ave
9 South
Boston, MA 02115-5724

Phone

(617) 355-0943

Fax

(617) 730-0795

NPI assigned

May 12, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksullivan26439@direct.bostonchildrens.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Hospital Pediatric Associates, Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1457306664
  Medicare reassignment NPD
• Childrens Hospital Boston

  • Children's Hospital
  • Boston, MA
  • NPI 1770741530
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1033386727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "9 SOUTH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-0943",
            "fax_number": "617-730-0795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "9 SOUTH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-0943",
            "fax_number": "617-730-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KERI",
        "middle_name": "J",
        "credential": "RN, MS, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "252927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Sullivan
• Kathleen Sullivan, PHARM.D., RPH
• Kathleen Marie Sullivan, NP
• Kathleen Ruth Sullivan, C.N.M.
• Kathryn Sullivan
• Kristin Marie Sullivan, PA-C
• Lara Sullivan, LICSW
• Lauren Michelle Sullivan, RN, AGCNS-BC
• Lee Sullivan, MD
• Leslie Jane Sullivan, NP

• Pediatric Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.