Colleen Marie Sullivan, RN/NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

083892-23 Issued in NH

Practice address

79 Swiftwater Rd
Woodsville, NH 03785-1447

Phone

(603) 747-3990

NPI assigned

Aug 12, 2013

Last updated

May 27, 2021By the provider in NPPES

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

Enrolled in MA, NH2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ammonoosuc Community Health Services, Inc.Group PAC ID 1052361664, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleensullivan@achs.medalliesdirect.net

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.

• Ammonoosuc Community Health Services Inc

  • Family Medicine Physician
  • Littleton, NH
  • NPI 1598716755

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ammonoosuc Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Franconia, NH
  • NPI 1275742660
  NPD
• Ammonoosuc Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Warren, NH
  • NPI 1982821765
  NPD (past)

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1770916959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "WATERVILLE VALLEY",
            "state": "NH",
            "postal_code": "032150537",
            "telephone_number": "978-771-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SWIFTWATER RD",
            "city": "WOODSVILLE",
            "state": "NH",
            "postal_code": "037851447",
            "telephone_number": "603-747-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Biltmore Ave",
            "address_purpose": "LOCATION",
            "city": "Chelmsford",
            "state": "MA",
            "postal_code": "018243202",
            "country_code": "US",
            "telephone_number": "978-771-8886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "COLLEEN",
        "middle_name": "MARIE",
        "credential": "RN/NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "083892-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaws Supermarkets Inc (Shaws Pharmacy #2535)
• Kristie Jo Shillinglaw, RPH
• Aaron Solnit, M.D.
• Loren Solnit, M.D.
• Spectrum Medical Management Services LLC
• Jack Sullivan
• The Alpine Clinc, PLLC
• Lisa Thompson, COTA/L
• Jessica Thornton-Sherman, PT
• Mary Christine Valliant, LPN

• Psychiatric/Mental Health Nurse Practitioner in Woodsville, NH
• Providers in Woodsville, NH by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.