Chance Sullivan, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

042-0016127 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(802) 847-2345

NPI assigned

Mar 24, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carepoint Emergency Medicine, PLLCGroup PAC ID 7810291432, 160 clinicians

The Memorial HospitalGroup PAC ID 1254231533, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sky Ridge Medical Center Hospital, Lone Tree, CO, CCN 060112
• HCA-Healthone Dba Swedish Medical Center Hospital, Englewood, CO, CCN 060034
• Memorial Hospital, the Hospital, Craig, CO, CCN 061314

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Carepoint Emergency Medicine, PLLC

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1134590318
  Medicare reassignment Care Compare group NPD
• The Memorial Hospital

  • Critical Access Hospital
  • Craig, CO
  • NPI 1063418424
  Medicare reassignment Care Compare group NPD
• St. Vincent General Hospital District

  • Critical Access Hospital
  • Leadville, CO
  • NPI 1457315152
  Medicare reassignment
• St. Vincent General Hospital District

  • Primary Care Clinic/Center
  • Leadville, CO
  • NPI 1497710958
  Medicare reassignment
• The Memorial Hospital

  • Land Ambulance
  • Craig, CO
  • NPI 1669288809
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Healthone LLC

  • General Acute Care Hospital
  • Englewood, CO
  • NPI 1396790200
  Care Compare affiliation
• HCA Healthone LLC

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1659325629
  Care Compare affiliation
• The Memorial Hospital

  • Critical Access Hospital
  • Craig, CO
  • NPI 1063418424
  Care Compare affiliation
• The Memorial Hospital

  • Land Ambulance
  • Craig, CO
  • NPI 1669288809

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1871053918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHANCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042-0016127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chance-sullivan@uiowa.edu",
            "affiliation": "N",
            "address_1": "111 Colchester Ave",
            "city": "Burlington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054011473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sue Shaffer PHD LLC
• Mark Sueyoshi
• Lauren Suggs, M.D.
• Nathaniel Isaac Sugiyama, M.D.
• Alison Sullivan
• Jeanne Sullivan, LICSW
• Jill Ann Sullivan, RD
• Jillian Sarah Sullivan, MD
• Keely Sullivan, NP
• Mariel Sullivan

• Emergency Medicine Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Emergency Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.