Justine Sullivan, C.R.N.F.A.

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

26NO05331500 Issued in NJ

Practice address

13 Elm Dr
Medford, NJ 08055-8840

Phone

(973) 957-0548

Fax

(866) 395-0888

NPI assigned

Oct 10, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Surgical Services of South Jersey, LLC

  • Skilled Nursing Facility
  • Medford, NJ
  • NPI 1336323104
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1497843239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ELM DR",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558840",
            "telephone_number": "973-957-0548",
            "fax_number": "866-395-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ELM DR",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558840",
            "telephone_number": "973-957-0548",
            "fax_number": "866-395-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JUSTINE",
        "credential": "C.R.N.F.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "NJ",
            "license": "26NO05331500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce John Roy Stroud, PT
• Stuart H. Levy, D.D.S., PA
• Erica Suarez
• Suburban Family Dental PC
• Sullivan Medical Equipment Co., Inc.
• Samantha Sumara
• William Luke Summers, PSYD
• Supportive Counseling Services
• Surgical Services of South Jersey, LLC
• Emily Sutin, MT-BC

• Registered Nurse First Assistant in Medford, NJ
• Providers in Medford, NJ by specialty
• Registered Nurse First Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.