Active NPI
Deborah Sullivan, RN/NP
- Primary Care Nurse Practitioner
- Burlington, MA
National Provider Identifier
1164816716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- RN161154
- Practice address
- 41 Mall Rd
Trauma Office 2T53
Burlington, MA 01805-0001 - Phone
- (781) 744-5006
- NPI assigned
- Mar 22, 2015
- 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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RN161154 | MA | Primary |
Addresses
Primary practice location
41 Mall Rd
Trauma Office 2T53
Burlington, MA 01805-0001
Mailing address
41 Mall Rd
Trauma Office, 2T53
Burlington, MA 01805-0001
Phone (781) 744-5006
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
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN161154 | MA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426982400000",
"number": "1164816716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MALL RD",
"address_2": "TRAUMA OFFICE, 2T53",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 MALL RD",
"address_2": "TRAUMA OFFICE 2T53",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "DEBORAH",
"credential": "RN/NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-22",
"last_updated": "2015-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MA",
"license": "RN161154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.