Kristina L Sullivan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

45817 Issued in WV

Practice address

800 Garfield Ave
Parkersburg, WV 26101-5340

Phone

(304) 424-2590

Fax

(304) 422-3924

NPI assigned

Oct 6, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Camden-Clark Physician Corporation

  • Surgery Physician
  • Parkersburg, WV
  • NPI 1710125430

  OH

  Medicare reassignment Care Compare group NPD
• United Anesthesia, Inc.

  • Anesthesiology Physician
  • Parkersburg, WV
  • NPI 1477512408

  Nurse Anesthetist, Certified Registered, OH

  Medicare reassignment NPD
• River Front Anesthesia Inc

  • Anesthesiology Physician
  • Belpre, OH
  • NPI 1578836565

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Camden Clark Memorial Hospital Corporation

  dba Camden Clark Medical Center

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  NPD (past)
• Columbia-St Josephs Heathcare System Limited Partnership

  dba Anesthesia Associates

  • Specialist
  • Parkersburg, WV
  • NPI 1104000256
  NPD (past)
• SJH Services Aa Inc

  • Anesthesiology Physician
  • Parkersburg, WV
  • NPI 1396072732
  NPD (past)

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

• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1508160268
  Care Compare affiliation
• Camden Clark Memorial Hospital Corporation

  dba Camden Clark Medical Center

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  Care Compare affiliation

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1083601892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 AVERY ST STE 501",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015192",
            "telephone_number": "304-422-3904",
            "fax_number": "304-422-3924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GARFIELD AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015340",
            "telephone_number": "304-424-2590",
            "fax_number": "304-422-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "45817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2441281",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2605395000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Stutler
• Leah Beth Suggs
• Jeanine Michele Suits
• Amy Sullivan
• Jessica L Sullivan, DPT
• Lisa Sullivan
• Michael Patrick Sullivan
• Miklynn Raeanne Pearl Sullivan
• Trudy Michelle Sullivan
• Raven J Sully

• Certified Registered Nurse Anesthetist in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.