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  7. NPI Record 1548654411

DONECIA PERRIN-SULLIVAN
Complete NPI Record 1548654411
Orthotic Fitter in Augusta, GA

NPI Status: Active since March 27, 2015

Contact Information

524 SHARTOM DR
AUGUSTA, GA
ZIP 30907
Phone: (706) 373-9184
Fax: (762) 333-8798

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Business Practice Location Address Fax Number
  18. Provider Enumeration Date
  19. Last Update Date
  20. Provider Gender Code
  21. Healthcare Provider Taxonomy Code 1
  22. Provider License Number 1
  23. Provider License Number State Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Healthcare Provider Taxonomy Code 2
  26. Provider License Number 2
  27. Provider License Number State Code 2
  28. Healthcare Provider Primary Taxonomy Switch 2
  29. Healthcare Provider Taxonomy Code 3
  30. Healthcare Provider Primary Taxonomy Switch 3
  31. Healthcare Provider Taxonomy Code 4
  32. Healthcare Provider Primary Taxonomy Switch 4
  33. Is Sole Proprietor
  34. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1548654411. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1548654411
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: DONECIA
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 505 PACIFICA DR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MARTINEZ
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: GA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 309071757
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 7063739184
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 524 SHARTOM DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: AUGUSTA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: GA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 309074751
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7063739184
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7623338798
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 3/27/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/2/2020
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 174400000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: CO093014
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: GA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 1744P3200X
Provider License Number 2: CO093014
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: GA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 225000000X
Healthcare Provider Primary Taxonomy Switch 3: Y
Healthcare Provider Taxonomy Code 4: 332B00000X
Healthcare Provider Primary Taxonomy Switch 4: N
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 4/2/2020