Active NPI
Adina Sullivan, RN
- School Registered Nurse
- Brentwood, NY
National Provider Identifier
1972184588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 635924-1
- Practice address
- 2 Mur PL
Brentwood, NY 11717-2934 - Phone
- (631) 972-2457
- Fax
- (631) 972-1547
- NPI assigned
- Apr 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 635924-1 | NY | Primary |
Addresses
Primary practice location
2 Mur PL
Brentwood, NY 11717-2934
Mailing address
2 Mur PL
Brentwood, NY 11717-2934
Phone (631) 972-2457
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 635924-1 | Other | NY | REGISTERED NURSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | adina.sullivan@bufsd.org | Health Information Exchange (HIE) | |
| Direct Messaging Address | adina.sullivan@bufsd.org | Direct |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 635924-1 | NY | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1972184588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MUR PL",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117172934",
"telephone_number": "631-972-2457",
"fax_number": "631-972-1547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MUR PL",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117172934",
"telephone_number": "631-972-2457",
"fax_number": "631-972-1547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ADINA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-15",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NY",
"license": "635924-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "635924-1",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "adina.sullivan@bufsd.org",
"affiliation": "N",
"endpointDescription": "e-mail",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "2 Mur Pl",
"city": "Brentwood",
"state": "NY",
"country_code": "US",
"postal_code": "117172934",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "adina.sullivan@bufsd.org",
"affiliation": "N",
"endpointDescription": "e-mail",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2 Mur Pl",
"city": "Brentwood",
"state": "NY",
"country_code": "US",
"postal_code": "117172934",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.