MRS. MARY ELLEN SULLIVAN (NPI# 1861676942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861676942 |
| Entity Type | Individual |
| Full Name | MRS. MARY ELLEN SULLIVAN |
| Credential | GNP-BC |
| Practice Address |
304 E Market St Agape Physicians Care Bennettsville SC 29512-3137 |
| Mailing Address |
1624 Main Street Agape Senior Primary Care, Inc., Dba Agape Physicians C Columbia SC 29201 |
| Practice Telephone | 8434793838 |
| Practice Fax Number | 8434793931 |
| Mailing Telephone | 8034540365 |
| Mailing Fax Number | 8034046000 |
| Enumeration Date | 2007-12-25 |
| Last Update Date | 2014-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
3428 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164570750 | Mary Ellen Sullivan | Registered Nurse | 3322 Chanate Rd, Santa Rosa, CA 95404-1708 | 2007-01-08 |
| Street Address |
304 E MARKET ST AGAPE PHYSICIANS CARE |
| City | BENNETTSVILLE |
| State | SC |
| Zip Code | 29512-3137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861841371 | Anna Paige Paul | Counselor | 1035 Cherau St, Bennettsville, SC 29512 | 2016-06-06 |
| 1821468679 | Kristen Dana Oliver | Social Worker | 1035 Cherow St., Bennettsville, SC 29512 | 2015-10-05 |
| 1285022749 | 3-points Coastal Care,llc | Community/Behavioral Health | 1300 West Main St, Bennettsville, SC 29512 | 2015-01-06 |
| 1437572328 | Terri Cardenas Woodham | Pharmacist | 336 Highway 9 West, Bennettsville, SC 29512 | 2014-01-28 |
| 1851712533 | Amy Kessler | Pharmacist | 336 Hwy 9 West, Bennettsville, SC 29512 | 2013-12-23 |
| 1346677184 | Daniel Louis Lockamy | Counselor | 284 Tatum Rd, Bennettsville, SC 29512 | 2013-10-10 |
| 1164772596 | Melissa Irene Pletan | Pharmacist | 1085 Cottingham Blvd, Ste 3, Bennettsville, SC 29512 | 2012-09-13 |
| 1730440769 | Cigna Onsite Health LLC | Non-Pharmacy Dispensing Site | 2094 Marlboro Rd, Bennettsville, SC 29512 | 2012-06-06 |
| 1649572710 | Ingram Health Service/manna House.inc | Case Management | 211 N Market Street, Bennettsville, SC 29512 | 2010-11-23 |
| 1952564387 | Gregory Wayne Alford | Community Health Worker | 610 State Street Ext, Bennettsville, SC 29512 | 2008-07-07 |
| Find all providers in zip 29512 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043152 | Lorenzo Ford | Nurse Practitioner | 20 Pioneer Ct, Sumter, SC 29150-9559 | 2020-08-13 |
| 1407484041 | Vistina Metts Johnson | Nurse Practitioner | 121 Executive Center Dr Ste 131, Columbia, SC 29210-8492 | 2020-03-30 |
| 1154969012 | William R. Andrews | Nurse Practitioner | 1516 Old Trolley Rd Ste 101, Summerville, SC 29485-8345 | 2019-12-11 |
| 1265078570 | Paula Nicole Allen | Nurse Practitioner | 133 Beaver Dam Rd, Columbia, SC 29223-3101 | 2019-11-21 |
| 1306497557 | Dina Martin | Nurse Practitioner | 171 Monroe Ln, Lexington, SC 29072-3904 | 2019-09-27 |
| 1053801720 | Kristin Marie Scarborough | Nurse Practitioner | 1470 Tobias Gadson Blvd Ste 203, Charleston, SC 29407-4925 | 2018-05-17 |
| 1922511054 | Anne Louise Grogan-hanford | Nurse Practitioner | 1317 Quail Vly W, Columbia, SC 29212-1554 | 2017-11-11 |
| 1972941821 | Jeanne Cameron Gonzalez | Nurse Practitioner | 504 Huntington Rd, Greenville, SC 29615-4212 | 2013-06-12 |
| 1508839739 | Vanessa Thompson | Nurse Practitioner | 391 Serpentine Dr Ste 400, Spartanburg, SC 29303-3081 | 2006-02-08 |
| 1053384537 | Robin H Starr | Nurse Practitioner | 603 Chestnut Rd, Myrtle Beach, SC 29572-5503 | 2006-02-07 |
| Find all providers with the same taxonomy | ||||
| City | BENNETTSVILLE |
| Zip Code | 29512 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.