Shannon Allison Sullivan

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

101 The City Drive S
City Tower, Ste 400
Orange, CA 92868

Phone

(714) 456-5691

Fax

(714) 456-8874

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: ssullivan30349@ehrdirect.uhhospitals.org

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.

• The Regents of the University of California-Irvine

  • Hospitalist Physician
  • Orange, CA
  • NPI 1154479723
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1730716010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S STE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE S",
            "address_2": "CITY TOWER, STE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-5691",
            "fax_number": "714-456-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHANNON",
        "middle_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Sullinger
• Brian Thomas Sullivan, MD
• Brittany Sullivan, M.D.
• Jasmine Faith Sullivan
• Leah Sullivan
• Dilara Sultana, PSYCHIATRY NURSE PRA
• Rylee Anne Sulzer
• Sharlyn Ann Sumbillo Park, MS CCC-SLP
• Leanne Brigh Sumbong
• Michael Summerlin, PH.D.

• Student in an Organized Health Care Education/Training Program in Orange, CA
• Providers in Orange, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.