Individual provider Active NPI

Nicole Elizabeth Sullivan, D.C.

  • Chiropractor
  • Bardstown, KY
National Provider Identifier
1154499036
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4982 Issued in KY
Practice address
214 W John Fitch Ave
Bardstown, KY 40004-1115
Phone
(502) 350-1314
Fax
(502) 350-1316
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4982 KY Primary

Addresses

Primary practice location

214 W John Fitch Ave
Bardstown, KY 40004-1115

Mailing address

214 W John Fitch Ave
Bardstown, KY 40004-1115
Phone (502) 350-1314

Other identifiers 1

IdentifierTypeStateIssuer
463476472OtherKYTAX ID

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

LicenseStateTypeSpecialty
4982KYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Chiropractic Center, PSC Chiropractor PastSince Jul 1, 1998 Accepting new patients
Frankfort Family Chiropractic PLLC Chiropractor Past Accepting new patients
Capitol Chiropractic and Injury Center Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1154499036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W JOHN FITCH AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041115",
            "telephone_number": "502-350-1314",
            "fax_number": "502-350-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W JOHN FITCH AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041115",
            "telephone_number": "502-350-1314",
            "fax_number": "502-350-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "463476472",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bardstown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.