Individual provider Active NPI

Erin E O'Sullivan, N.P.

  • Gerontology Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1558339887
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
29491 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-3623
Phone
(615) 322-3000
NPI assigned
Mar 11, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 208041 MA
Gerontology Nurse Practitioner 363LG0600X 29491 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-3623

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

91 Montvale Ave
Suite 208
Stoneham, MA 02180-3623
Phone (781) 279-1123

Other identifiers 2

IdentifierTypeStateIssuer
0700142MedicaidMA
NP1550OtherMABCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eosullivan649963@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000225 MA Practitioner - Nurse Practitioner 8628052040 Reassigns benefits to 3 organizations
Practice locations: Boston, MA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
208041MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health System Inc Gerontology CurrentSince Nov 8, 2016 Accepting new patients
Integrated Wound Care Massachusetts PLLC CurrentSince Dec 9, 2018 Accepting new patients
Hallmark Health Medical Associates Inc CurrentSince Sep 1, 2018 Accepting new patients
Melrosewakefield Healthcare, Inc. Current Accepting new patients
Melrosewakefield Healthcare, Inc. CurrentSince Nov 8, 2016 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Past Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

91 Montvale Ave
Ste 208
Stoneham, MA 02180
Phone (781) 279-1123

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

Interoperability endpoints

  • Direct secure messaging: eosullivan45833@tuftsmedicine.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1558339887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372323623",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Montvale Ave",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Stoneham",
            "state": "MA",
            "postal_code": "021803623",
            "country_code": "US",
            "telephone_number": "781-279-1123",
            "fax_number": "781-438-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "ERIN",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "208041",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "29491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0700142",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NP1550",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eosullivan649963@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372323623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.