Active NPI
Jennifer D Sullivan
- School Registered Nurse
- Martinsburg, WV
National Provider Identifier
1235836313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 85270
- Practice address
- 109 S College St
Martinsburg, WV 25401-3307 - Phone
- (304) 267-3595
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 85270 | WV | Primary |
Addresses
Primary practice location
109 S College St
Martinsburg, WV 25401-3307
Mailing address
109 S College St
Martinsburg, WV 25401-3307
Phone (304) 267-3595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85270 | WV | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1235836313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 S COLLEGE ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254013307",
"telephone_number": "304-267-3595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 S COLLEGE ST",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254013307",
"telephone_number": "304-267-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JENNIFER",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "WV",
"license": "85270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinsburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.