Chandlyr Marie Sullivan

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

7010 Hascall St Apt 307
Omaha, NE 68106-3596

Phone

(402) 875-0689

NPI assigned

Jan 18, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1750032017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 BARBARA ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 HASCALL ST APT 307",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063596",
            "telephone_number": "402-875-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHANDLYR",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann M Sullivan, MD
• Anne Louise Sullivan
• Bart Sullivan
• Bradley Sullivan
• Brianna Lynn Sullivan, LIMHP
• Courtney D Sullivan, ACNP
• Elizabeth Sullivan
• Emily Sullivan, MS, BCBA, LABA
• Erin C Sullivan, MA, OT
• James Sullivan

• Athletic Trainer in Omaha, NE
• Providers in Omaha, NE by specialty
• Athletic Trainer in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.