Active NPI
Darrian Renee Sullivan, DNP
- Family Nurse Practitioner
- Merrillville, IN
National Provider Identifier
1073147989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 28204072A
- Practice address
- 5825 Broadway
Merrillville, IN 46410-2687 - Phone
- (219) 689-3199
- NPI assigned
- Feb 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28204072A | IN | Primary |
Addresses
Primary practice location
5825 Broadway
Merrillville, IN 46410-2687
Mailing address
197 W 76TH Ave
Merrillville, IN 46410-4728
Phone (219) 689-3199
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28204072A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582934400000",
"number": "1073147989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 W 76TH AVE",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464104728",
"telephone_number": "219-689-3199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5825 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464102687",
"telephone_number": "219-689-3199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "DARRIAN",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-29",
"last_updated": "2020-02-29",
"certification_date": "2020-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "28204072A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.