Individual provider Active NPI

Christine Veronica Sullivan, FNP-C

  • Family Nurse Practitioner
  • Newark, DE
National Provider Identifier
1376308809
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0012480 Issued in DE
Practice address
620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134
Phone
(302) 600-1124
NPI assigned
Feb 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X LG-0012480 DE Primary

Addresses

Primary practice location

620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134

Mailing address

620 Stanton Christiana Rd Ste 101
Newark, DE 19713-2134
Phone (302) 600-1124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240405001367 DE Practitioner - Nurse Practitioner 1557709862 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates, LLC Family CurrentSince Mar 6, 2024 Accepting new patients
Delaware Sleep Disorder Centers, LLC Current Accepting new patients
Delaware Sleep Disorder Centers, LLC CurrentSince Feb 10, 2024 Accepting new patients
Delaware Sleep Disorder Centers, LLC CurrentSince Feb 10, 2024 Accepting new patients
Premier Medical Associates Family CurrentSince Mar 6, 2024 Accepting new patients
Saramaya LLC Past Accepting new patients

Locations

620 Stanton Christiana Rd
Ste 101
Newark, DE 19713
Phone (302) 449-9314

701 Foulk Rd
Ste 1G
Wilmington, DE 19803
Phone (302) 368-3300

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1376308809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 STANTON CHRISTIANA RD STE 101",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132134",
            "telephone_number": "302-600-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 STANTON CHRISTIANA RD STE 101",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132134",
            "telephone_number": "302-600-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTINE",
        "middle_name": "VERONICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0012480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.