Arlene Sullivan, ANP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

A01250 Issued in AR

Practice address

9500 Kanis Rd
Hickingbotham Outpatient Center
Little Rock, AR 72205-6324

Phone

(501) 202-1902

Fax

(501) 202-1512

NPI assigned

Jul 27, 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 5

Medicare fee-for-service enrollment

Enrolled in AR

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asullivan4710@direct.baptist-healthar.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.

• Arkansas Health Group

  • Sleep Medicine (Internal Medicine) Physician
  • Little Rock, AR
  • NPI 1831103811
  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD
• Arkansas Health Group

  • Family Medicine Physician
  • White Hall, AR
  • NPI 1316286149
  NPD (past)
• Arkansas Health Group

  • Family Medicine Physician
  • Sheridan, AR
  • NPI 1548239247
  NPD (past)
• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1205850542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-202-1902",
            "fax_number": "501-202-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD",
            "address_2": "HICKINGBOTHAM OUTPATIENT CENTER",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056324",
            "telephone_number": "501-202-1902",
            "fax_number": "501-202-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ARLENE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A01250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "71-0781138",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5U030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "71-0781138028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "742252",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7525325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Edith Suggs, PHARMD
• Catherine Louise Sukup
• Samir David Sulieman Jr.
• Nagla Suliman
• Angela Sullivan, CRNA
• Charles David Sullivan
• Dennis Henry Sullivan, M.D.
• Elizabeth Ann Sullivan, M. D.
• Elizabeth Carey Sullivan, MD
• Ellen Sullivan, APN

• Acute Care Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.