Active NPI
Shondra Sullivan, RN
- Registered Nurse
- Winter Springs, FL
National Provider Identifier
1528627502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9492951
- Practice address
- 580 Old Sanford Oviedo Rd
Winter Springs, FL 32708-2637 - Phone
- (407) 215-0095
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
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 Nurse | 163W00000X | RN9492951 | FL | Primary |
Addresses
Primary practice location
580 Old Sanford Oviedo Rd
Winter Springs, FL 32708-2637
Mailing address
580 Old Sanford Oviedo Rd
Winter Springs, FL 32708-2637
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN9492951 | Other | FL | BOARD OF NURSING |
Other names 1
- Shondra Thomas
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ssullivan@impowerfl.org | Direct |
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9492951 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1528627502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 OLD SANFORD OVIEDO RD",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327082637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 OLD SANFORD OVIEDO RD",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327082637",
"telephone_number": "407-215-0095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SHONDRA",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9492951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF NURSING",
"identifier": "RN9492951",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ssullivan@impowerfl.org",
"affiliation": "N",
"endpointDescription": "Email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "580 Old Sanford Oviedo Rd",
"city": "Winter Springs",
"state": "FL",
"country_code": "US",
"postal_code": "327082637",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SHONDRA",
"last_name": "THOMAS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winter Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.