Active NPI
Anna Rose Sullivan
- Registered Nurse
- Southborough, MA
National Provider Identifier
1114464724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN2260715
- Practice address
- 18 Maplecrest Dr
Southborough, MA 01772-1241 - Phone
- (508) 481-3845
- NPI assigned
- Jan 22, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN2260715 | MA | |
| Registered Nurse | 163W00000X | RN2260715 | MA | Primary |
Addresses
Primary practice location
18 Maplecrest Dr
Southborough, MA 01772-1241
Mailing address
18 Maplecrest Dr
Southborough, MA 01772-1241
Phone (508) 481-3845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2260715 | MA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1114464724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 MAPLECREST DR",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721241",
"telephone_number": "508-481-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 MAPLECREST DR",
"city": "SOUTHBOROUGH",
"state": "MA",
"postal_code": "017721241",
"telephone_number": "508-481-3845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ANNA",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-22",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN2260715",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2260715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.