Joanne Marie Sullivan, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

225133 Issued in MA

Practice address

950 Winter St
Suite 3800
Waltham, MA 02451-1424

Phone

(781) 472-8515

NPI assigned

Dec 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1427113539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "address_2": "SUITE 3800",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "781-472-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WINTER ST",
            "address_2": "SUITE 3800",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511424",
            "telephone_number": "781-472-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "225133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0374130",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Sturtz
• Succor Primary Care Inc
• Faith Rose Sudbey, LCSW
• Diane Marie Sullivan, B.A.
• Helen Rodolakis Sullivan, L.M.H.C.
• Maryellen Sullivan, NP
• Meghan Summerton, RBT
• Hyung Seok Sung
• Jinsil Kim Sung, M.D.
• Supportive Circle Home Care Inc

• Gerontology Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.