Sarah Hazlegrove Sullivan, MS, RD, LDN

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

LDN2202 Issued in TN

Practice address

711 Jefferson Ave
Memphis, TN 38105-5003

Phone

(901) 448-6511

Fax

(901) 448-7097

NPI assigned

Feb 1, 2010

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 2

Other names 1

• Ms. Sarah E Hazlegrove Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ssullivan18120@direct.seattlechildrens.org

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.

• Sprouts Nutrition LLC

  • Registered Dietitian
  • Matthews, NC
  • NPI 1811726656
  NPD Authorized official

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1982936092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055003",
            "telephone_number": "901-448-6511",
            "fax_number": "901-448-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055003",
            "telephone_number": "901-448-6511",
            "fax_number": "901-448-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SARAH",
        "middle_name": "HAZLEGROVE",
        "name_prefix": "Mrs.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "TN",
            "license": "LDN2202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "103I711459",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519010",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "HAZLEGROVE",
            "middle_name": "E",
            "prefix": "MS.",
            "credential": "MS. RD. LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jasmine Alexandra Sullivan
• Joshua Wade Sullivan, PHARM.D.
• Mary Kathleen Sullivan, DNP, FNP, RN
• Meghan Dale Jackson Sullivan, M.D.
• Patrick Scott Sullivan, MD
• William Micaiah Sullivan, R.N.
• Willie Floyd Sullivan Jr., M.S.
• Henry Paul Sullivant Jr., MD
• Ibrahim A Sultan-Ali, MD
• Amer Adnan Sultan, MD

• Metabolic Nutrition Registered Dietitian in Memphis, TN
• Providers in Memphis, TN by specialty
• Metabolic Nutrition Registered Dietitian in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.