Jerrilyn N Sullivan, D.C.

Primary specialty

NutritionistTaxonomy code 133N00000X

License

1120493 Issued in NH

Practice address

46 Bridge St
Nashua, NH 03060-3576

Phone

(603) 882-7769

NPI assigned

Apr 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Specialty

Chiropractic

Education

Sherman College of Straight Chiropractic, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Chiropractic LLCGroup PAC ID 8325260409, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Main Street Chiropractic, LLC

  • Family Nurse Practitioner
  • Nashua, NH
  • NPI 1154752392
  Medicare reassignment Care Compare group NPD Authorized official
• Deborah Miller

  dba Body Balance Rehab Therapy

  • Occupational Therapist
  • Nashua, NH
  • NPI 1356618441
  NPD (past)

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1609192970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 BRIDGE ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 BRIDGE ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603576",
            "telephone_number": "603-882-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JERRILYN",
        "middle_name": "N",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "NH",
            "license": "1120493",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NH",
            "license": "1120493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenkere G Sudhir, M.D.
• Kelsey Sukerman, BA
• Lisa Marie Sullender, BS, RN, HN-BC
• Brendon Sullivan, MSW
• Christine Sullivan, BA
• Kristen D. Sullivan, AUD., CCC-A
• Olivia Carmela Sullivan, AGACNP
• Philip Wright Sullivan, MD
• Suma Rajesh,DMD,PLLC
• Tanya Summa

• Nutritionist in Nashua, NH
• Providers in Nashua, NH by specialty
• Nutritionist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.