Mikaelyn Sullivan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0996096-NP Issued in CO

Practice address

4055 Valley View LN Ste 400
Dallas, TX 75244-5071

Phone

(972) 715-3800

NPI assigned

Dec 27, 2020

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yampa Valley Medical CenterGroup PAC ID 5890685689, shared by 3 NPIs, 128 clinicians

Northwest Colorado Visiting Nurse AssociationGroup PAC ID 3173617883, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchealth Yampa Valley Medical Center Hospital, Steamboat Springs, CO, CCN 060049

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GJDGAA

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.

• Northwest Colorado Visiting Nurse Association

  • Community Health Clinic/Center
  • Craig, CO
  • NPI 1073693677
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment
• Northwest Colorado Visiting Nurse Association

  • Skilled Nursing Facility
  • Steamboat Springs, CO
  • NPI 1316764517
  NPD
• Northwest Colorado Visting Nurse Association

  • Federally Qualified Health Center (FQHC)
  • Craig, CO
  • NPI 1063663292
  NPD
• Northwest Colorado Visiting Nurse Association

  • Federally Qualified Health Center (FQHC)
  • Steamboat Springs, CO
  • NPI 1265787857
  NPD (past)

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

• Yampa Valley Medical Center

  • General Acute Care Hospital
  • Oak Creek, CO
  • NPI 1164081345
  Care Compare affiliation
• Yampa Valley Medical Center

  • General Acute Care Hospital
  • Hayden, CO
  • NPI 1295394203
  Care Compare affiliation
• Yampa Valley Medical Center

  • General Acute Care Hospital
  • Steamboat Springs, CO
  • NPI 1790787307
  Care Compare affiliation

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1154918092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 CENTRAL PARK DR",
            "address_2": "STE 101",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804878853",
            "telephone_number": "972-715-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445071",
            "telephone_number": "972-715-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MIKAELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-27",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996096-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Tujague Sullivan, PA-C
• Leslie Sullivan, LCSW
• Leticia Sanchez Sullivan, LCSW
• Luke Edward Sullivan
• Macy Crabb Sullivan, RN
• Nicole Sullivan, LMSW
• Paul Jeffrey Sullivan, MD
• Sharel Sullivan
• Shelley Lynn Sullivan, LPC
• Sierra Gabriella Sullivan, RN

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.