Individual provider Active NPI

Kristin S Sullins, OD

  • Optometrist
  • Huntsville, AL
National Provider Identifier
1265628796
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SB64 Issued in AL
Practice address
210 Bob Wallace Ave SW
Huntsville, AL 35801-3809
Phone
(256) 539-3454
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SB64 AL Primary

Addresses

Primary practice location

210 Bob Wallace Ave SW
Huntsville, AL 35801-3809

Mailing address

210 Bob Wallace Ave SW
Huntsville, AL 35801-3809

Other identifiers 1

IdentifierTypeStateIssuer
SB64OtherSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080129000451 AL Practitioner - Optometry 3072695113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Associates, Inc.Group PAC ID 0749254001, 52 clinicians

Practice addresses (Care Compare)

210 Bob Wallace Ave SW
Huntsville, AL 35801-3809
Phone (256) 539-3454

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SB64ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Vision Center, LLC Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Eyecare Associates, Inc. Optometrist CurrentSince May 21, 2017 Accepting new patients
Eyecare Associates, Inc. CurrentSince May 21, 2017 Accepting new patients
Eyecare Associates, Inc. Optometrist Current Accepting new patients
Eyecare Associates, Inc. Past Accepting new patients

Locations

7191 Cahaba Valley Rd
Ste 203
Hoover, AL 35242
Phone (205) 236-9943

3810 Governors Dr NW
Unit 201
Huntsville, AL 35805

210 Bob Wallace Ave SW
Huntsville, AL 35801
Phone (256) 539-3454

7880 Old Madison Pike
Madison, AL 35758
Phone (256) 772-8711

3928 Montclair Rd
Ste 100
Mountain Brk, AL 35213
Phone (205) 871-1713

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ksullins@direct.eyecare-partners.com
  • Direct secure messaging: ks@avchuntsville.direct.eyemdemr.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1265628796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BOB WALLACE AVE SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013809",
            "telephone_number": "256-539-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLINS",
        "first_name": "KRISTIN",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SB64",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SB64",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.