Nicole Anne Sullivan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

12631 Issued in MA

Practice address

7000 Great Meadow Rd
Dedham, MA 02026-4090

Phone

(781) 234-9500

NPI assigned

Mar 19, 2020

Last updated

Mar 19, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1538795794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 GREENDALE AVE # 2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 GREAT MEADOW RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264090",
            "telephone_number": "781-234-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021384308",
            "country_code": "US",
            "telephone_number": "617-876-4344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Sturgeon, LICSW
• Edward T Sullivan
• Jennifer Marie Sullivan, OT/L
• Jill Sullivan
• Juliet Helene Sullivan, OD
• Kortney Sumner, LCSW
• Xuefei Sun
• Sundry Care, LLC.
• Doneige Tanis Suprice, BSN, RN
• Cassie Sutton

• Occupational Therapist in Dedham, MA
• Providers in Dedham, MA by specialty
• Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.