Individual provider Active NPI

Noreen M Sullivan, D.C.

  • Chiropractor
  • Santa Fe, NM
National Provider Identifier
1184755712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
564 Issued in NM
Practice address
1301 Luisa St
Suite H
Santa Fe, NM 87505-7001
Phone
(505) 982-0691
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 564 NM Primary

Addresses

Primary practice location

1301 Luisa St
Suite H
Santa Fe, NM 87505-7001

Mailing address

1301 Luisa St
Suite H
Santa Fe, NM 87505-7001
Phone (505) 982-0691

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070622000434 NM Practitioner - Chiropractic 9931208568 Practice locations: Santa Fe, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184755712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 LUISA ST",
            "address_2": "SUITE H",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057001",
            "telephone_number": "505-982-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 LUISA ST",
            "address_2": "SUITE H",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057001",
            "telephone_number": "505-982-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NOREEN",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.