Individual provider Active NPI

Elizabeth Marie Sullivan

  • Occupational Therapist
  • Providence, RI
National Provider Identifier
1598958167
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT01159 Issued in RI
Practice address
1000 Eddy St
Providence, RI 02905-4739
Phone
(401) 533-9100
NPI assigned
Aug 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT01159 RI Primary

Addresses

Primary practice location

1000 Eddy St
Providence, RI 02905-4739

Mailing address

1000 Eddy St
Providence, RI 02905-4739
Phone (401) 533-9100

Other identifiers 9

IdentifierTypeStateIssuer
292177OtherRIEI BCROSS
412296OtherRIEI BCHIP
6400144OtherRIUNITED
99947OtherRIBCROSS
2058OtherRINHPRC
2092OtherRIEI NHPRC
9009994MedicaidRI
ES01788MedicaidRI
6400144OtherRIEI UNITED

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

State licenses

LicenseStateTypeSpecialty
OT01159RIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting Street Center Past Accepting new patients
Meeting Street Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: esullivan@wih.cernerdirect.carene.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1598958167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054739",
            "telephone_number": "401-533-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054739",
            "telephone_number": "401-533-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "RI",
            "license": "OT01159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BCROSS",
            "identifier": "292177",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI BCHIP",
            "identifier": "412296",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "6400144",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCROSS",
            "identifier": "99947",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRC",
            "identifier": "2058",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI NHPRC",
            "identifier": "2092",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9009994",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ES01788",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EI UNITED",
            "identifier": "6400144",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.