Annamarie Sullivan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC5170 Issued in FL

Practice address

611 E Adams St
Jacksonville, FL 32202-2847

Phone

(904) 559-9025

NPI assigned

Jun 25, 2013

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: annamarie.sullivan.1@21075.direct.athenahealth.com

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.

• Im Sulzbacher Center for the Homeless, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1710051354
  Medicare reassignment NPD
• Im Sulzbacher Center for the Homeless, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1396369187
  NPD

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1740620673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-559-9025",
            "fax_number": "904-861-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E ADAMS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322022847",
            "telephone_number": "904-559-9025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 6th Ave S Ste 500",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322504200",
            "country_code": "US",
            "telephone_number": "904-224-3550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANNAMARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SIOKG",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DOH OPTOMETRY LICENSE",
            "identifier": "OPC5170",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julian Stephen Suhrer, MD
• Marianny Nazareth Sulbaran Nava, MD, PH.D.
• Ilkhom Suleymanov
• Stephanie Sulkala
• Ann Nicole Sullivan, PA-C
• David Kevin Sullivan, D.M.D.
• Deyja Sullivan
• Gloria Cherish Hope Sullivan, CRNA
• Helen Sullivan, LDO
• Jacqueline Sullivan, BCBA

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.