NPIMap

Individual provider Active NPI

Abigail J Sullivan, MSN, FNP-C

  • Family Nurse Practitioner
  • New London, NH
National Provider Identifier
1205511508
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
074008-23 Issued in NH
Practice address
276 Newport Rd # 107
New London, NH 03257
Phone
(603) 526-4144
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 074008-21 NH
Family Nurse Practitioner 363LF0000X 074008-23 NH Primary

Addresses

Primary practice location

276 Newport Rd # 107
New London, NH 03257

Mailing address

276 Newport Rd # 107
New London, NH 03257-5468
Phone (603) 526-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220002356 NH Practitioner - Nurse Practitioner 9931559796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Life Long Care of New London PLLC 5 clinicians

Practice addresses (Care Compare)

276 Newport Rd
Suite 107
New London, NH 03257-5468
Phone (603) 526-4144

Hospital & facility affiliations

  • Lake Sunapee Home Care & Hospice Home health agency, New London, NH, CCN 307040
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • Concord Hospital Hospital, Concord, NH, CCN 300001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
074008-21NHMDRegistered Nurse
074008-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Life Long Care of New London PLLC Family CurrentSince Nov 30, 2023 Accepting new patients

Locations

276 Newport Rd
Ste 107
New London, NH 03257
Phone (603) 344-1819

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23658/brand/1/csg/1/fhir/r4
  • Direct secure messaging: abigail.sullivan.1@23658.direct.athenahealth.com

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1205511508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 NEWPORT RD # 107",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575468",
            "telephone_number": "603-526-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 NEWPORT RD # 107",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "03257",
            "telephone_number": "603-526-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ABIGAIL",
        "middle_name": "J",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "074008-21",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "074008-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, NH

Sources for this page

Verify at the official NPI Registry.