Carol Sullivan, CASE MANAGER

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT8614 Issued in NM

Practice address

602 Weinrich Rd TRLR 6
Las Cruces, NM 88007-4857

Phone

(575) 496-1162

NPI assigned

Aug 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1629324017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 WEINRICH RD TRLR 6",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074857",
            "telephone_number": "575-339-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 WEINRICH RD TRLR 6",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074857",
            "telephone_number": "575-496-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CAROL",
        "credential": "CASE MANAGER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NM",
            "license": "MT8614",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "NM",
            "license": "MT8614",
            "primary": false
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "NM",
            "license": "MT8614",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "MT8614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74481",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Suazo, NP
• David A Sudimack, DDS
• Christina Suessbrich-Joaquim, P.T.
• Jin Ho Suh, CASE MANAGER
• Rita Suina, M.D.
• Chelsea Sullivan, BCBA
• Courtney Sullivan
• Gary Sullivan
• Lisa Kay Sullivan, SLP
• Nowshin Sultana

• Massage Therapist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Massage Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.