Jessie Mae Sullivan, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

5353 N Union Blvd Ste 201-D
Colorado Springs, CO 80918-2065

Phone

(720) 515-2181

NPI assigned

Apr 24, 2012

Last updated

Mar 17, 2018By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1225396575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 N UNION BLVD STE 201-D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809182065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 N UNION BLVD STE 201-D",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809182065",
            "telephone_number": "720-515-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12647 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416393",
            "country_code": "US",
            "telephone_number": "800-325-3982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JESSIE",
        "middle_name": "MAE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleigh Joe Sullivan
• Connor Philip Sullivan
• Deborah A Sullivan, NP
• Eric Sullivan, PHARM.D
• Jessica Sullivan, CCC-SLP
• Kathryn Harriet Sullivan, RPH
• Katie E. Sullivan, PT, DPT, NCS
• Kelly Colleen Sullivan, MA, PLMHP
• Kevin Sullivan
• Maribel Sullivan

• Registered Dietitian in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Registered Dietitian in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.