Deborah S Sullivan, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R524239 Issued in MS

Practice address

595 Main St E
Meadville, MS 39653-9233

Phone

(601) 384-3199

Fax

(601) 384-3950

NPI assigned

Sep 19, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Field Memorial Community Hospital

  • Rural Health Clinic/Center
  • Woodville, MS
  • NPI 1881648376
  Medicare reassignment NPD
• Field Memorial Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Centreville, MS
  • NPI 1447217526
  NPD
• Field Memorial Community Hospital

  • Critical Access Hospital
  • Centreville, MS
  • NPI 1871633347
  NPD
• Franklin County Memorial Hospital

  • Clinic/Center
  • Meadville, MS
  • NPI 1295866168
  NPD (past)

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1174620652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 MAIN ST E",
            "address_2": "P.O. BOX 636",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396539233",
            "telephone_number": "601-384-3199",
            "fax_number": "601-384-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 MAIN ST E",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396539233",
            "telephone_number": "601-384-3199",
            "fax_number": "601-384-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DEBORAH",
        "middle_name": "S",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R524239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120619",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scherer Chiropractic LLC
• Herman Shane Smith
• Southwest Mississippi Planning and Development District
• Stage 1 Hair Loss Replacement & Salon
• Stage 1 Hair Loss Replacement & Salon LLC
• Super-Save Drugs
• Alanda Knight Tillman
• Amanda Deann Ward
• Lori Wroten, NP-C
• Benjamin Yarbrough, MD

• Family Nurse Practitioner in Meadville, MS
• Providers in Meadville, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.