COLLEEN MARIE SULLIVAN (PA-C) – Physician Assistant, NPI 1952319501
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,329 PHYSICIAN ASSISTANT in NC
Provider Addresses for COLLEEN MARIE SULLIVAN (PA-C)
PO BOX 5105
BELFAST, ME 049155100
Phone: (919) 220-5255
Type: Mailing
2076 HIGHWAY 42 WEST
CLAYTON, NC 275205302
Phone: (919) 763-1050
Type: Location
Providence Road, Providence, Charlotte, Mecklenburg County, North Carolina, 28277, United States
SUITE 101
CHARLOTTE, NC 282071468
Phone: (704) 749-5800
Fax: (704) 626-3067
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-03-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050308000413 | I | Physician Assistant | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 04915)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NC | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | NC | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | NC | |
| Nurse Practitioner | OR |
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