Active NPI
Patricia Sullivan
- Community Health Nurse Practitioner
- Delta, CO
National Provider Identifier
1790954816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Nurse Practitioner
- License
- 2050
- Practice address
- 255 W 6TH St
Delta, CO 81416-1626 - Phone
- (970) 874-2165
- Fax
- (970) 874-2175
- NPI assigned
- Feb 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Nurse Practitioner | 363LC1500X | 2050 | CO | Primary |
Addresses
Primary practice location
255 W 6TH St
Delta, CO 81416-1626
Mailing address
255 W 6TH St
Delta, CO 81416-1626
Phone (970) 874-2165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07020506 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2050 | CO | MD | Community Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta County Health Dept | Past | Accepting new patients | |
| Delta County Health Dept | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health or Welfare Agency
- Delta, CO
- NPI 1770512964
-
- Registered Nurse
- Delta, CO
- NPI 1801296645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1790954816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W 6TH ST",
"city": "DELTA",
"state": "CO",
"postal_code": "814161626",
"telephone_number": "970-874-2165",
"fax_number": "970-874-2175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W 6TH ST",
"city": "DELTA",
"state": "CO",
"postal_code": "814161626",
"telephone_number": "970-874-2165",
"fax_number": "970-874-2175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "PATRICIA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-22",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": "CO",
"license": "2050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07020506",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Delta, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.