Active NPI
Jo Ellen Sullivan, R. PH.
- Pharmacist
- Taylorsville, MS
National Provider Identifier
1972682979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E08820
- Practice address
- 305 Front Street
Taylorsville, MS 39168 - Phone
- (601) 785-6812
- NPI assigned
- Nov 2, 2006
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | E08820 | MS | Primary |
Addresses
Primary practice location
305 Front Street
Taylorsville, MS 39168
Mailing address
PO Box 1351
Taylorsville, MS 39168-1351
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 Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E08820 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972682979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1351",
"city": "TAYLORSVILLE",
"state": "MS",
"postal_code": "391681351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 FRONT STREET",
"city": "TAYLORSVILLE",
"state": "MS",
"postal_code": "39168",
"telephone_number": "601-785-6812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JO",
"middle_name": "ELLEN",
"credential": "R. PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E08820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.