Individual provider Active NPI

Li Chin Sun, NP-C

  • Adult Health Nurse Practitioner
  • Concord, MA
National Provider Identifier
1275991168
Registry record updated Oct 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2264759 Issued in MA
Practice address
131 Ornac Ste 610
Concord, MA 01742-4162
Phone
(978) 371-7778
NPI assigned
Feb 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2264759 MA Primary

Addresses

Primary practice location

131 Ornac Ste 610
Concord, MA 01742-4162

Mailing address

131 Ornac Ste 610
Concord, MA 01742-4162
Phone (978) 371-7778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202001435 MA Practitioner - Nurse Practitioner 1254614936 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Krishma Medical Associates 2 PC CurrentSince Dec 1, 2022 Accepting new patients
Krishma Medical Associates PC CurrentSince Jan 3, 2017 Accepting new patients

Locations

131 Ornac
Ste 610
Concord, MA 01742
Phone (978) 369-7772

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476576000000",
    "number": "1275991168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ORNAC STE 610",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424162",
            "telephone_number": "978-371-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ORNAC STE 610",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424162",
            "telephone_number": "978-371-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "LI",
        "middle_name": "CHIN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2264759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.