Lucy Mackinnon Sullivan

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86300512 Issued in MD

Practice address

4820 31St St S Ste B
Arlington, VA 22206-1665

Phone

(703) 865-6490

NPI assigned

Jul 2, 2024

Last updated

Jul 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in DC, VA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lucy.sullivan.1@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Medical Associates of Central Virginia, Inc.

  • Internal Medicine Physician
  • Lynchburg, VA
  • NPI 1912970260
  NPD (past)

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1215773031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6630 81ST ST",
            "city": "CABIN JOHN",
            "state": "MD",
            "postal_code": "208181205",
            "telephone_number": "410-980-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 31ST ST S STE B",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222061665",
            "telephone_number": "703-865-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LUCY",
        "middle_name": "MACKINNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "86300512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Suellentrop, MSW
• Kaitlyn Payne Sugden, FNP
• Pride Suh
• Alexandra Grace Fellows Sullivan, LCSW
• Jane Mary Sullivan, PMHNP-BC
• Mark Ford Sullivan, M.D.
• Michele Martin Sullivan, RN
• Zain Jalal Sultan, MD
• Kevin D Sumida, MD
• Jevene Marie Summers, MSPT

• Registered Dietitian in Arlington, VA
• Providers in Arlington, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.