Active NPI
Kristin S Sullins, OD
- Optometrist
- Huntsville, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- SB64
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SB64 | Other | STATE 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
210 Bob Wallace Ave SW
Huntsville, AL 35801-3809
Phone (256) 539-3454
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 50 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SB64 | AL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama Vision Center, LLC | Optometrist | Current | Accepting new patients |
| Eyecare Associates, Inc. | Optometrist | Current | Accepting new patients |
| Eyecare Associates, Inc. | Current | 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
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- ksullins@direct.eyecare-partners.com
- 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.
-
- Eyewear Supplier
- Huntsville, AL
- NPI 1336274257
-
- Optometrist
- Montgomery, AL
- NPI 1871475038
-
- Durable Medical Equipment & Medical Supplies
- Jasper, AL
- NPI 1255490041
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.