Active NPI
Carole E Sullivan, CRNP
- Family Nurse Practitioner
- Gaithersburg, MD
National Provider Identifier
1609350982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R191548
- Practice address
- 201 Perry Parkway Suite 5
Gaithersburg, MD 20877 - Phone
- (240) 801-8686
- NPI assigned
- Sep 21, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R191548 | MD | Primary |
Addresses
Primary practice location
201 Perry Parkway Suite 5
Gaithersburg, MD 20877
Mailing address
3719 Gelderland CT
Olney, MD 20832
Phone (240) 277-0899
Other names 1
- Carole E Hachem
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1609350982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3719 GELDERLAND CT",
"city": "OLNEY",
"state": "MD",
"postal_code": "20832",
"telephone_number": "240-277-0899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PERRY PARKWAY SUITE 5",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "20877",
"telephone_number": "240-801-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CAROLE",
"middle_name": "E",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-21",
"last_updated": "2021-11-04",
"certification_date": "2021-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R191548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLE",
"last_name": "HACHEM",
"middle_name": "E",
"credential": "CRNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.