Courtney D Sullivan, ACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

111234 Issued in NE

Practice address

8111 Dodge St
Suite 363
Omaha, NE 68114-4129

Phone

(402) 354-8155

NPI assigned

Aug 27, 2008

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

• Courtney Beckmann Former name

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/49ec4064-7609-4f62-b5e6-20a05e00549b/

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.

• Alegent Creighton Health

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1033288923

  Nurse Practitioner

  Medicare reassignment NPD
• Alegent Creighton Health

  • Community/Retail Pharmacy
  • Lincoln, NE
  • NPI 1598423220
  NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD (past)
• Infectious Diseases Associates PC

  • Infectious Disease Physician
  • Omaha, NE
  • NPI 1164448510
  NPD (past)
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD (past)

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1346497757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "address_2": "SUITE 363",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 DODGE ST",
            "address_2": "SUITE 363",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144129",
            "telephone_number": "402-354-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "COURTNEY",
        "middle_name": "D",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209007230",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "BECKMANN",
            "credential": "ACNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anne Louise Sullivan
• Bart Sullivan
• Bradley Sullivan
• Brianna Lynn Sullivan, LIMHP
• Chandlyr Marie Sullivan
• Elizabeth Sullivan
• Emily Sullivan, MS, BCBA, LABA
• Erin C Sullivan, MA, OT
• James Sullivan
• James Leahy Sullivan, MD

• Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.