Active NPI
Sandra Sullivan
- Personal Care Attendant
- Boise, ID
National Provider Identifier
1568127124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 6700 W Overland Rd
Boise, ID 83709-2032 - Phone
- (208) 319-4587
- Fax
- (208) 377-3883
- NPI assigned
- Nov 8, 2021
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
6700 W Overland Rd
Boise, ID 83709-2032
Mailing address
6700 W Overland Rd
Boise, ID 83709-2032
Phone (208) 319-4587
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0000141 | Medicaid | ID |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Able 2 Link U | Current | Accepting new patients | |
| Able @ Link U | Current | Accepting new patients |
Locations
6700 W Overland Rd
Boise, ID 83709
Phone (208) 319-4587
Organizations & group practices 2
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.
-
- Emergency Response System Companies
- Boise, ID
- NPI 1710688189
-
- Emergency Response System Companies
- Boise, ID
- NPI 1134004724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636329600000",
"number": "1568127124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6700 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837092032",
"telephone_number": "208-319-4587",
"fax_number": "208-377-3883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837092032",
"telephone_number": "208-319-4587",
"fax_number": "208-377-3883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-08",
"last_updated": "2021-11-08",
"certification_date": "2021-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A0000141",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.