Carisa R Sullivan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP129122 Issued in TX

Practice address

6010 W Amarillo Blvd BLDG West
Amarillo, TX 79106-1990

Phone

(806) 355-9703

Fax

(806) 468-1500

NPI assigned

Sep 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1326418658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 W AMARILLO BLVD BLDG WEST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061990",
            "telephone_number": "806-355-9703",
            "fax_number": "806-468-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 W AMARILLO BLVD BLDG WEST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061990",
            "telephone_number": "806-355-9703",
            "fax_number": "806-468-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Coulter St",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061786",
            "country_code": "US",
            "telephone_number": "806-414-9650",
            "fax_number": "806-354-5730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CARISA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP129122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200615620 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77376714",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352922401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352922402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Stubbs, CRNA
• Melynda Anne Sturdevant, RN
• Zabrinia Suber, MS, CCC-SLP
• Muhammad Subhani, MD
• Sivaram Sudhakar, M.D.
• Crystal Summers, COTA
• Surgery Center of Amarillo, LLC
• Susan B Goetz MD PA
• James Kirby Sutterfield, MA, LPC-S, LCDC
• Misty Dawn Sutton, FNP-C

• Family Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.