Laura Rose Sullivan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5018138 Issued in NC

Practice address

4600 Oleander Dr
Wilmington, NC 28403-5149

Phone

(910) 392-1921

NPI assigned

May 18, 2023

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

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Locust, NC
  • NPI 1144803040
  Medicare reassignment NPD
• Mainstreet and Kidsstreet of North Carolina PLLC

  • Urgent Care Clinic/Center
  • Burlington, NC
  • NPI 1043170558
  NPD

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1942991187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035149",
            "telephone_number": "910-392-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035149",
            "telephone_number": "910-392-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphne Caroline Suits, LCMHCA
• Jordan Zachary Suits, LCSWA
• Emily Sullivan
• Jaclyn Sullivan, MA COUNSELING
• Jesse Danielle Sullivan, MSW, LCSWA
• Michael Durgin Sullivan, M.D.
• Riley Sullivan
• Tristan Colby Sullivan
• Michele Renee Sulwer, DPT
• David Lee Summerfield, RN,NP-C,CNOR,RNFA

• Family Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.