Anne Lorraine Self Sullivan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD47894 Issued in TN

Practice address

1520 Union Ave
Memphis, TN 38174-0275

Phone

(901) 276-2410

NPI assigned

Sep 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Anne Lorraine Sullivan Other name

Medicare fee-for-service enrollment

Enrolled in TN, MS2 enrollments

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 2

Specialty

Family Practice

Education

University of Iowa, RJ & L Carver College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asullivan14793@direct.bmhcc.org

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.

• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Family Medicine, MS

  Medicare reassignment Care Compare group NPD
• Baptist Memorial Medical Group Inc

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD
• Family Physicians Group PC

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1457344145
  NPD (past)
• Eastern Iowa Health Center

  • Community/Retail Pharmacy
  • Cedar Rapids, IA
  • NPI 1346048675
  NPD (past)
• Eastern Iowa Health Center

  • Family Medicine Physician
  • Cedar Rapids, IA
  • NPI 1578753703
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1114913555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381740275",
            "telephone_number": "901-276-2410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7736 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715306",
            "country_code": "US",
            "telephone_number": "662-772-5222",
            "fax_number": "662-772-5957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANNE",
        "middle_name": "LORRAINE SELF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "29526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD47894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "SULLIVAN",
            "middle_name": "LORRAINE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ali Y Suliman, MD, MSC
• Allison M. Sulkowski, M.A., CCC-SLP
• Sydney Claire Sullicant, OT
• Michael A Sullivan-Tibbs, LCSW, LCAC
• Adrienne Claire Sullivan
• Catherine Brooke Sullivan, PHARM.D.
• Chuck Sullivan
• Courtney Sullivan
• David Wayne Sullivan, M.D.
• Gwyneth A Sullivan

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.