Heidi Sullivan, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN106514 Issued in GA

Practice address

102 Bryan Woods Road
Savannah, GA 31410-1225

Phone

(912) 898-1122

Fax

(912) 898-9944

NPI assigned

Jul 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heidi Hasbrouck Former name

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Candler Hospital Hospital, Savannah, GA, CCN 110024

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sullivanh@direct.sjchs.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.

• SJC Medical Group Inc

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1811233828
  Medicare reassignment Care Compare group NPD
• Candler ENT Practice, LLC

  • Otolaryngology Physician
  • Savannah, GA
  • NPI 1477969749
  NPD (past)
• Candler Medical Group, Inc. - Islands

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1811913486
  NPD (past)
• St. Joseph'S Cardiology Group, LLC

  • Interventional Cardiology Physician
  • Savannah, GA
  • NPI 1619216058
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1295188498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 20",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BRYAN WOODS ROAD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314101225",
            "telephone_number": "912-898-1122",
            "fax_number": "912-898-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "HEIDI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN106514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181045B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "HASBROUCK",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyajuana Suggs-Williamson, LCSW
• Lauryn Suggs, RBT
• Daniel V Suh, MD
• Sullivan Health Management
• Daniel M Sullivan, DO
• John Patrick Sullivan, PA-C
• Lori Elizabeth Sullivan, LMT
• Megan Summerlin, M.S.
• Adrian Summers
• Roland Steven Summers, MD

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.