Maura Ann Sullivan-Moore, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

123432 Issued in MA

Practice address

150 S Huntington Ave
Jamaica Plain, MA 02130-4817

Phone

(617) 232-9500

NPI assigned

Oct 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205926508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 HIGH ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023323428",
            "telephone_number": "781-585-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-MOORE",
        "first_name": "MAURA",
        "middle_name": "ANN",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "123432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliza Strode, LICSW
• Paulette Strother, LADC II
• Srila Sen Subash, LCSW
• Aditi Subramaniam, LMHC
• Robert D. Sullaway, MSW
• Jeannine Balbiers Sullivan, RD
• Kelly Anne Sullivan, LCSW
• Margaret M Sullivan, NP
• Mary-Christine Sullivan, N.P.
• Abubakarr Sumah

• Adult Health Nurse Practitioner in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.