Individual provider Active NPI

Amy Sullivan

  • Family Nurse Practitioner
  • Cabot, AR
National Provider Identifier
1053735639
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004030 Issued in AR
Practice address
5830 Highway 5
Cabot, AR 72023-7328
Phone
(501) 941-1376
Fax
(501) 941-2793
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004030 AR Primary

Addresses

Primary practice location

5830 Highway 5
Cabot, AR 72023-7328

Mailing address

117 S 2ND St
PO Box 497
Augusta, AR 72006-2309
Phone (870) 347-2534

Other identifiers 1

IdentifierTypeStateIssuer
201310758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140409000510 AR Practitioner - Nurse Practitioner 1355573213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ArcareGroup PAC ID 2567370620, 249 clinicians

Practice addresses (Care Compare)

5830 Hwy 5
Cabot, AR 72023-7328
Phone (501) 941-1376

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arcare Current Accepting new patients
Arcare CurrentSince Feb 12, 2014 Accepting new patients
Arcare Past Accepting new patients

Locations

623 N 9th St
#40
Augusta, AR 72006

117 S 2nd St
Augusta, AR 72006

5830 Highway 5
Cabot, AR 72023
Phone (501) 941-1376

Interoperability endpoints

  • Direct secure messaging: amy.sullivan@arcare.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1053735639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 2ND ST",
            "address_2": "PO BOX 497",
            "city": "AUGUSTA",
            "state": "AR",
            "postal_code": "720062309",
            "telephone_number": "870-347-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 HIGHWAY 5",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237328",
            "telephone_number": "501-941-1376",
            "fax_number": "501-941-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201310758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cabot, AR

Sources for this page

Verify at the official NPI Registry.