Individual provider Active NPI

Lisa A Sullivan, APNP

  • Nurse Practitioner
  • La Crosse, WI
National Provider Identifier
1326029935
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
633 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 633 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20040928001141 WI Practitioner - Nurse Practitioner 7113996976 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Health Services, Inc. CurrentSince Nov 1, 2022 Accepting new patients
St. Joseph'S Health Services, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Apr 26, 2016 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Apr 26, 2016 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Nov 1, 2022 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Gundersen Clinic LTD CurrentSince Feb 21, 2007 Accepting new patients
Tri-County Memorial Hospital, Inc. Current Accepting new patients
Memorial Hospital of Boscobel CurrentSince Nov 1, 2022 Accepting new patients
St. Joseph'S Health Services, Inc. Current Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Nov 1, 2022 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Feb 21, 2007 Accepting new patients

Locations

610 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-4311

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

Interoperability endpoints

  • Direct secure messaging: lsullivan6715@direct.emplifyhealth.org

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1326029935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.