Johnna Kathryn Sullivan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP023057 Issued in PA

Practice address

312 S Henderson Rd
King of Prussia, PA 19406-2408

Phone

(610) 205-1264

NPI assigned

Jan 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic of Pennsylvania LLCGroup PAC ID 5395827307, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Minuteclinic Diagnostic of Pennsylvania LLC

  • Family Nurse Practitioner
  • Bryn Mawr, PA
  • NPI 1881738037
  Medicare reassignment Care Compare group NPD
• Medical Group of New York, P.C.

  • Family Nurse Practitioner
  • Eastchester, NY
  • NPI 1487983516
  Medicare reassignment NPD
• Minuteclinic Video Virtual Care, PLLC

  • Family Nurse Practitioner
  • Woonsocket, RI
  • NPI 1316402746

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1356930804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S HENDERSON RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062408",
            "telephone_number": "610-205-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S HENDERSON RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062408",
            "telephone_number": "610-205-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JOHNNA",
        "middle_name": "KATHRYN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F347007-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C. Stuber, PH.D.
• Elaine Sturm, RPH
• Suburban Medical Services, LLC
• Success Chiropractic LLC
• Rachel Alexandra Sugarman, D.O.
• Anna Sulpizio
• Zakiyyah Suluki, CERTIFIED HAIR LOSS
• Sun Dental PC
• Angela Hua Sun, DMD
• Yong Sun, D.M.D., PH D

• Family Nurse Practitioner in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.