Active NPI
Patricia Mary Sullivan, MS RD LDN
- Registered Dietitian
- Wescosville, PA
National Provider Identifier
1467657072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN002548
- Practice address
- 6083 Hamilton Boulevard
Wescosville, PA 18106 - Phone
- (610) 597-1512
- NPI assigned
- Jun 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN002548 | PA | Primary |
Addresses
Primary practice location
6083 Hamilton Boulevard
Wescosville, PA 18106
Mailing address
5393 Princeton Road
Macungie, PA 18062
Phone (610) 509-9383
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3762201 | Other | AETNA LIFE INSURANCE COMP | |
| SU1794305 | Other | PA | HIGHMARK BLUE SHIELD |
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467657072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5393 PRINCETON ROAD",
"city": "MACUNGIE",
"state": "PA",
"postal_code": "18062",
"telephone_number": "610-509-9383",
"fax_number": "610-965-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6083 HAMILTON BOULEVARD",
"city": "WESCOSVILLE",
"state": "PA",
"postal_code": "18106",
"telephone_number": "610-597-1512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "PATRICIA",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "MS RD LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN002548",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA LIFE INSURANCE COMP",
"identifier": "3762201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "SU1794305",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wescosville, PA
- Kimberly Ring, M.S.,LPC
- Teather Lynne Royse, PA-C
- Sacred Heart Healthcare System (Sacred Heart Pediatric Associates - Trexlertown)
- Carol Anne Skinner
- Ashley Elizabeth Stuart, DDS
- Sunrise Pediatric Therapy, P.C.
- Nancy L Trawin, ED.D.
- John Charles Turoczi, ED.D.
- Mark E Velarde, MD
- Laura M Zagacki, MS OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.