JESSICA JEANNE SULLIVAN (NPI# 1982142519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982142519 |
| Entity Type | Individual |
| Full Name | JESSICA JEANNE SULLIVAN |
| Other Name | MS. JESSICA JEANNE SULLIVAN |
| Credential | NP |
| Practice Address |
300 Mount Auburn St Cambridge MA 02138-5600 |
| Mailing Address |
921 E 4th St South Boston MA 02127-3214 |
| Practice Telephone | 6178680847 |
| Mailing Telephone | 6179975904 |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN2306549 | MA | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN2306549 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 921 E 4th St, Boston, MA 021273214 | 6179975904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497380778 | Jessica Sullivan | Nurse Practitioner | 2024 Willow Pond Way, Grafton, WI 53024-9101 | 2020-03-07 |
| 1114567351 | Jessica Sullivan | Licensed Practical Nurse | 4854 Dragoo Rd, Nashport, OH 43830-9613 | 2020-01-15 |
| 1205321775 | Jessica Marie Sullivan | Behavior Technician | 28 Laurel Rd, Milton, MA 02186-1522 | 2018-06-27 |
| 1245731280 | Jessica Sullivan | Physical Therapist | 106 Tonkin St, Beaverton, MI 48612-8116 | 2018-02-26 |
| 1508265737 | Jessica Page Sullivan | Nurse Practitioner | 10 W Madison St Ste 11, Baltimore, MD 21201 | 2014-08-13 |
| 1700217502 | Jessica Sullivan | Speech-Language Pathologist | 435 S Sunset Dr, El Centro, CA 92243-5553 | 2013-12-03 |
| 1699108944 | Jessica Nicole Sullivan | Occupational Therapist | 210 S County Road 675 W, North Vernon, IN 47265-7536 | 2013-08-09 |
| 1396085304 | Jessica C Sullivan | Social Worker | 360 State Route 17m, Suite 4, Monroe, NY 10950-3443 | 2013-02-28 |
| 1285994160 | Jessica Rea Sullivan | Social Worker | 15 Belcher St, Sharon, MA 02067-1305 | 2012-05-24 |
| 1336448984 | Jessica Marie Sullivan | Counselor | 6497 Parkland Dr Ste 103d, Sarasota, FL 34243-4097 | 2011-03-22 |
| Street Address |
300 MOUNT AUBURN ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466316 | Frederick W Ruymann | Internal Medicine | 300 Mount Auburn St, Ste 405, Cambridge, MA 02138-5665 | 2005-06-09 |
| 1134688120 | Peymaan Sam Banankhah | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2019-03-18 |
| 1508389636 | Emily Holmes | Nurse Practitioner | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-07-20 |
| 1396277455 | Dr. Susan Pories | Surgery | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2017-03-29 |
| 1992243554 | Allison Vandermeulen | Specialist/Technologist, Other | 300 Mount Auburn St, Suite 505, Cambridge, MA 02138-5600 | 2017-02-03 |
| 1578017497 | Andrew Dallahan Donnelly | Registered Nurse | 300 Mount Auburn St, Suite 517, Cambridge, MA 02138-5600 | 2016-08-09 |
| 1447634670 | Troy Tweiten | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2015-07-17 |
| 1235528696 | Laura Boldyrev | Nurse Practitioner | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2015-01-22 |
| 1649673724 | Cambridge Digestive Health PC | Internal Medicine | 300 Mount Auburn St, Suite 405, Cambridge, MA 02138-5600 | 2014-10-02 |
| 1609206739 | Cynthia Waite | Nurse Practitioner | 300 Mount Auburn St, Physician Associates At Mount Auburn Hospital Suite 410, Cambridge, MA 02138-5600 | 2013-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
| Find all providers in zip 02138 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518916519 | Kimberly Ann Goc | Nurse Practitioner | 300 Mount Auburn St, Ste 517, Cambridge, MA 02138-5600 | 2006-05-08 |
| 1841257904 | Marie Cosma | Nurse Practitioner | 300 Mount Auburn St, Ste 517, Cambridge, MA 02138-5600 | 2006-05-01 |
| 1922081801 | Phyllis J Inman | Nurse Practitioner | Youville Hospital, 1575 Cambridge Street, Cambridge, MA 02138-4398 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018370 | Ashley Erin Dimauro | Nurse Practitioner | 155 Federal St Ste 700, Boston, MA 02110-1727 | 2019-11-18 |
| 1780228924 | Jeffrey J Benoit | Nurse Practitioner | 103 Upper Rd, Deerfield, MA 01342-9739 | 2019-10-31 |
| 1962064626 | Katharine Kingsley Campbell | Nurse Practitioner | 50 Orchardhill Rd, Jamaica Plain, MA 02130-3725 | 2019-07-02 |
| 1124502737 | Rebecca Gaffney | Nurse Practitioner | 200 Mill Rd Ste 190, Fairhaven, MA 02719-5259 | 2018-09-19 |
| 1154821114 | Caroline Namuzinda Mawanda | Nurse Practitioner | 8 Baron Park Ln Apt 20, Burlington, MA 01803-5453 | 2018-02-16 |
| 1205334588 | Mary Torkornoo | Nurse Practitioner | 430 Massasoit Rd, Worcester, MA 01604-3546 | 2018-01-31 |
| 1508374406 | Kristin Tyrrell Chouinard | Nurse Practitioner | Home Md, 75 Sylvan St., Danvers, MA 01923-0192 | 2018-01-14 |
| 1962921379 | Krysta L Doucette | Nurse Practitioner | 47 High Street Suite 101, North Andover, MA 01845-5201 | 2017-09-18 |
| 1366961310 | Christine Anna Corallino | Nurse Practitioner | 14 Foster Street, #3, Boston, MA 02109 | 2017-09-11 |
| 1922546407 | Lisa Marie Joyce | Nurse Practitioner | 321 Manley St, West Bridgewater, MA 02379 | 2017-02-06 |
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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.