Individual provider Active NPI

Alison Sullivan, RN

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1114646551
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025550 Issued in CA
Practice address
2521 Stockton Blvd Ste 3
Sacramento, CA 95817-2207
Phone
(916) 734-3112
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95025550 CA Primary
Diabetes Educator Registered Nurse 163WD0400X 95166671 CA

Addresses

Primary practice location

2521 Stockton Blvd Ste 3
Sacramento, CA 95817-2207

Mailing address

2521 Stockton Blvd
Sacramento, CA 95817-2207

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address msasullivan@ucdavis.edu Other
Direct Messaging Address msasullivan@ucdavis.edu Other
Direct Messaging Address msasullivan@ucdavis.edu Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20250114000092 CA Practitioner - Nurse Practitioner 3971031378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95166671CAMDDiabetes Educator Registered Nurse
95025550CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Mar 7, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Feb 3, 2025 Accepting new patients
Regents of the University of California CurrentSince Mar 7, 2025 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Feb 3, 2025 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

1535 River Park Dr
Ste 2000
Sacramento, CA 95815
Phone (916) 286-1010

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 2200
Sacramento, CA 95817
Phone (916) 734-2222

2521 Stockton Blvd
Ste 3
Sacramento, CA 95817
Phone (916) 734-3112

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1114646551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD STE 3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ALISON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025550",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "95166671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msasullivan@ucdavis.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact only",
            "address_1": "2521 Stockton Blvd Ste 3",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958172207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msasullivan@ucdavis.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact only",
            "address_1": "2521 Stockton Blvd Ste 3",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958172207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msasullivan@ucdavis.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact only",
            "address_1": "2521 Stockton Blvd Ste 3",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958172207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.