Shannon Sullivan

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20196000263 Issued in CO

Practice address

14095 E Exposition Ave
Aurora, CO 80012-2522

Phone

(303) 309-3647

NPI assigned

Jun 17, 2019

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

Other identifiers 1

Electronic endpoints 1

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1295395853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14095 E EXPOSITION AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122522",
            "telephone_number": "303-309-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14095 E EXPOSITION AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122522",
            "telephone_number": "303-309-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CO",
            "license": "20196000263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS TAX ID",
            "identifier": "273201143",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.autismcommunitystore.com",
            "affiliation": "N",
            "endpointDescription": "desktop computers",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14095 E Exposition Ave",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800122522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lorie Beth Sullivan, LPN
• Maegan Sullivan
• Raymond Sullivan
• Rebecca Joy Sullivan, MD
• Sarah H Sullivan, MD
• Siobhan Sullivan, PT
• Stephanie Leigh Sullivan
• Suman Morarka MD LLC
• Summerbrook Dental Group, LLC
• Steven Patrick Summers, MD

• Durable Medical Equipment & Medical Supplies in Aurora, CO
• Providers in Aurora, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.