Active NPI
Jacqueline Florentino Sullivan, ARNP
- Internist Chiropractor
- Jupiter, FL
National Provider Identifier
1124451547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- 9264181
- Practice address
- 920 W Indiantown Rd
Suite 107
Jupiter, FL 33458-6847 - Phone
- (561) 747-7707
- NPI assigned
- Aug 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 9264181 | FL | Primary |
Addresses
Primary practice location
920 W Indiantown Rd
Suite 107
Jupiter, FL 33458-6847
Mailing address
920 W Indiantown Rd
Suite 107
Jupiter, FL 33458-6847
Phone (561) 747-7707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9264181 | Other | FL | ARNP |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9264181 | FL | MD | Internist Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Medical Center of Jupiter, PA | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377043200000",
"number": "1124451547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 W INDIANTOWN RD",
"address_2": "SUITE 107",
"city": "JUPITER",
"state": "FL",
"postal_code": "334586847",
"telephone_number": "561-747-7707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 W INDIANTOWN RD",
"address_2": "SUITE 107",
"city": "JUPITER",
"state": "FL",
"postal_code": "334586847",
"telephone_number": "561-747-7707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JACQUELINE",
"middle_name": "FLORENTINO",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-21",
"last_updated": "2013-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Internist",
"state": "FL",
"license": "9264181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARNP",
"identifier": "9264181",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.