Individual provider Active NPI

Lauren Kathleen Sullivan, RD,LD

  • Registered Dietitian
  • Cleveland, OH
National Provider Identifier
1629393384
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
6386 Issued in OH
Practice address
9500 Euclid Ave
Desk M17
Cleveland, OH 44195-0001
Phone
(216) 445-1733
NPI assigned
Apr 6, 2010
Last updated
Apr 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 6386 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Desk M17
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave
Desk M17
Cleveland, OH 44195-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000129 OH Practitioner - Registered Dietitian Or Nutrition Professional 3870623556 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Apr 29, 2010 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#M17
Cleveland, OH 44195
Phone (216) 444-6103

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1629393384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK M17",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK M17",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAUREN",
        "middle_name": "KATHLEEN",
        "credential": "RD,LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "6386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.