Nicholas C Sullivan, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

APN.0991074-NP Issued in CO

Practice address

501 E Hampden Ave
Englewood, CO 80113-2702

Phone

(303) 761-9190

Fax

(720) 874-4462

NPI assigned

Feb 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Radiology Imaging of Nebraska, LLC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1184869901
  NPD (past)

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1154745784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17528",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802170528",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E HAMPDEN AVE",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132702",
            "telephone_number": "303-761-9190",
            "fax_number": "720-874-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICHOLAS",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0991074-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51558769",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154745784",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154745784",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Sturdy, O.D.
• Kaylee Annice Sturgis, LCSW
• Subspecialty Imaging Partners Prof, LLC
• Jamie Sullivan, PA
• Janel Sullivan, MS
• Summit Headache and Neurologic Institute, PC
• Summit Primary Care
• Summit Surgical Services
• Sunbeth Corporation
• Michael Sundeen, MS, ATC

• Acute Care Nurse Practitioner in Englewood, CO
• Providers in Englewood, CO by specialty
• Acute Care Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.