Scott Patric Sullivan, M.H.A.,A.T.C, R.K.T.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

609 Issued in CO

Practice address

205 S Main St
Suite C
Longmont, CO 80501-1716

Phone

(303) 684-9525

Fax

(303) 774-7899

NPI assigned

Nov 3, 2011

Last updated

Nov 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1033496179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 RED MOUNTAIN DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805042277",
            "telephone_number": "303-684-9525",
            "fax_number": "303-774-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST",
            "address_2": "SUITE C",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011716",
            "telephone_number": "303-684-9525",
            "fax_number": "303-774-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SCOTT",
        "middle_name": "PATRIC",
        "name_prefix": "Mr.",
        "credential": "M.H.A.,A.T.C, R.K.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CO",
            "license": "609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Stype, OTR
• Priya Subramanian, DPT
• Rebecca Suckow, PT, DPT
• Kelley M Sullivan, LCSW
• Paul Richard Sullivan
• Summey Chiropractic P.C.
• Summit Neuromonitoring LLC
• Summit Wellness Group Inc
• Mary Sundblom
• Carissa Supry, DC

• Athletic Trainer in Longmont, CO
• Providers in Longmont, CO by specialty
• Athletic Trainer in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.