Donna L Sullivan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30139 Issued in CO

Practice address

1025 Pennock PL
Fort Collins, CO 80524-3257

Phone

(970) 495-8800

Fax

(970) 495-8820

NPI assigned

Jan 3, 2006

Last updated

Jun 12, 2014By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1831177625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DONNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01301399",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ellen Sugar, MSW
• Alecxandr Patrick Sugrue, MSW
• Katherine Rae Suiter
• Suites Fort Collins LLC (The Suites Fort Collins)
• Daira Suljovic, LPCC, MA
• Hadleigh Anne Sullivan
• Kelly Sullivan, CAC III, QMAP, BA
• Laura Sullivan, RN
• Mary Sullivan, MFT
• Sharyl Sullivan, PTA

• Family Medicine Physician in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.