Individual provider Active NPI

Rebecca Oyler Sullivan, CRNA

  • Registered Nurse
  • Charleston, WV
National Provider Identifier
1083639421
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
35119 Issued in WV
Practice address
100 Peyton Way
Ste 200
Charleston, WV 25309-8767
Phone
(304) 720-8816
Fax
(904) 494-6467
NPI assigned
Jul 13, 2006
Last updated
Oct 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 35119 WV Primary

Addresses

Primary practice location

100 Peyton Way
Ste 200
Charleston, WV 25309-8767

Mailing address

PO Box 3466
Charleston, WV 25334-3466
Phone (304) 346-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
35119WVMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Day Surgery Limited Liability Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
River Cities Anesthesia PLLC Past Accepting new patients
Professional Anesthesia Service,Inc. Past Accepting new patients
Day Surgery Limited Liability Past Accepting new patients
Center for Pain Relief, Inc. Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1083639421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3466",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253343466",
            "telephone_number": "304-346-9400",
            "fax_number": "304-345-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEYTON WAY",
            "address_2": "STE 200",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253098767",
            "telephone_number": "304-720-8816",
            "fax_number": "904-494-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECCA",
        "middle_name": "OYLER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "35119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.