Shelby Jo Sullivan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

101759 Issued in NE

Practice address

2900 S 70TH St Ste 450
Lincoln, NE 68506-3796

Phone

(402) 730-0230

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shelby Jo Spicka Former name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Anesthesiologists, PCGroup PAC ID 4385630391, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryan Medical Center Hospital, Lincoln, NE, CCN 280003
• Lincoln Surgical Hospital Hospital, Lincoln, NE, CCN 280127

Merit-based Incentive Payment System (MIPS)

Final score

83 of 100Reported as group

Quality

80

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Associated Anesthesiologists PC

  • Anesthesiology Physician
  • Lincoln, NE
  • NPI 1972674604
  Medicare reassignment Care Compare group NPD

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

• Bryan Medical Center

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1528006103
  Care Compare affiliation
• Bryan Medical Center

  • Clinical Medical Laboratory
  • Lincoln, NE
  • NPI 1689203077

  Hospital

  Care Compare affiliation
• Bryan Medical Center

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1699384370

  Hospital

  Care Compare affiliation
• Lincoln Surgery Center LLC

  • Special Hospital
  • Lincoln, NE
  • NPI 1306849005
  Care Compare affiliation

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1306578638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S 70TH ST STE 450",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S 70TH ST STE 450",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063796",
            "telephone_number": "402-730-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHELBY",
        "middle_name": "JO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "81623",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "101759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "SPICKA",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenton R Sullivan, MD
• Lisa M Sullivan, M.D.
• Lydia Sullivan
• Mary Elizabeth Sullivan, MSW
• Michael J. Sullivan III, M.D.
• Susan Kay Sullivan
• Tahneceya Raizel Sullivan
• Timothy Joseph Sullivan, M.D.
• Trenton Sullivan
• Wendy Sullivan

• Certified Registered Nurse Anesthetist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Certified Registered Nurse Anesthetist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.