Katie Michelle Sullivan, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R240224 Issued in MD

Practice address

8630 Fenton St Ste 1200
Silver Spring, MD 20910-3808

Phone

(240) 839-5811

Fax

(301) 495-0318

NPI assigned

Jul 28, 2020

Last updated

Jul 28, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1558970251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 FENTON ST STE 1204",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103808",
            "telephone_number": "240-839-5811",
            "fax_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8630 FENTON ST STE 1200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103808",
            "telephone_number": "240-839-5811",
            "fax_number": "301-495-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KATIE",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R240224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nazaarah.bell@cciweb.org",
            "affiliation": "N",
            "endpointDescription": "credentialing department email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Silver Spring",
            "address_1": "8630 Fenton St Ste 1200",
            "city": "Silver Spring",
            "state": "MD",
            "country_code": "US",
            "postal_code": "209103808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Suk, RN, PMHNP-BC
• Hawa Sulaiman
• Abdelwahab Alamin Suliman, MD
• Andrea D Sullivan
• Constance H Sullivan, PT
• Mark Sullivan
• Megan Elizabeth Sullivan
• Sarah Sullivan, LCSW-C
• Ghousia Sultana, M.D.
• Sumana Kafle DDS, LLC (Silver Spring Pediatric Dentistry)

• Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.