Pamela Ann Sullivan, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

106412 Issued in MO

Practice address

1000 Edgewater Pointe
Suite: 200
Lake St. Louis, MO 63367

Phone

(636) 561-8088

Fax

(636) 561-1405

NPI assigned

Mar 9, 2006

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 1

Other names 1

• Mrs. Pamela Ann Kent Other name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians

Heartland Women'S Healthcare Mo PCGroup PAC ID 7618236415, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: psullivan21802@direct-ehr-ssmhc.com
• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• Direct secure messaging: pamela.sullivan.1@21608.direct.athenahealth.com

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.

• Heartland Women'S Healthcare Mo PC

  • Obstetrics & Gynecology Physician
  • Wentzville, MO
  • NPI 1588191431

  MO, Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• SSM Health Care St Louis

  • Emergency Medicine Physician
  • Fenton, MO
  • NPI 1275586174

  MO

  Medicare reassignment Care Compare group NPD
• Heartland Women'S Healthcare Mo PC

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1356849616
  NPD
• Progress West Healthcare Center

  • General Acute Care Hospital
  • O Fallon, MO
  • NPI 1508938044
  NPD (past)
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380
  NPD (past)
• Heartland Women'S Healthcare LTD

  • Clinical Medical Laboratory
  • Swansea, IL
  • NPI 1043852932
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Lake St Louis, MO
  • NPI 1871665380

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1033187828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EDGEWATER POINTE",
            "address_2": "SUITE - 200",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-561-8088",
            "fax_number": "636-561-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EDGEWATER POINTE",
            "address_2": "SUITE: 200",
            "city": "LAKE ST. LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-561-8088",
            "fax_number": "636-561-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "106412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208094821",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "KENT",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Obstetrics & Gynecology Physician in Lake St. Louis, MO
• Providers in Lake St. Louis, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.