Individual provider Active NPI

Kaitlin O'Sullivan, AGACNP

  • Acute Care Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1194486324
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN255834 Issued in GA
Practice address
11705 Mercy Blvd
Savannah, GA 31419-1711
Phone
(912) 819-5999
NPI assigned
Jan 10, 2022
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN255834 GA Primary
Gerontology Nurse Practitioner 363LG0600X RN255834 GA

Addresses

Primary practice location

11705 Mercy Blvd
Savannah, GA 31419-1711

Mailing address

340 Hodgson CT Ste 4
Savannah, GA 31406-1523
Phone (912) 927-6270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20251104004305 GA Practitioner - Nurse Practitioner 4183114564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Chattanooga, TN 37422

PO Box
Suite 22757
Chattanooga, TN 37422-2757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN255834GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Lung & Critical Care Specialists CurrentSince Aug 28, 2025 Accepting new patients
Southeast Lung & Critical Care Specialists, P.C. CurrentSince Aug 28, 2025 Accepting new patients

Locations

601 E General Stewart Way
Hinesville, GA 31313
Phone (912) 355-4557

131 Silverwood Ct
Ste 100
Rincon, GA 31326
Phone (912) 826-3927

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

340 Hodgson Ct
Ste 2
Savannah, GA 31406
Phone (912) 590-5797

340 Hodgson Ct
Ste 4
Savannah, GA 31406
Phone (912) 429-0841

Organizations & group practices 2

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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1194486324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 HODGSON CT STE 4",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061523",
            "telephone_number": "912-927-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 MERCY BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191711",
            "telephone_number": "912-819-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "KAITLIN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN255834",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN255834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.