Cassie Sullivan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6726-33 Issued in WI

Practice address

501 Gopher Dr
Tomah, WI 54660-4513

Phone

(608) 372-2181

NPI assigned

Dec 9, 2015

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: csullivan635915@direct.emplifyhealth.org

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.

• Mile Bluff Medical Center Inc

  • Emergency Medicine Physician
  • Mauston, WI
  • NPI 1609912005
  Medicare reassignment NPD
• Reedsburg Area Medical Center, Inc.

  • Critical Access Hospital
  • Reedsburg, WI
  • NPI 1891796710
  Medicare reassignment NPD
• Mile Bluff Medical Center Inc

  • Urgent Care Clinic/Center
  • Mauston, WI
  • NPI 1437958683
  NPD
• Mile Bluff Medical Center Inc

  • Rural Health Clinic/Center
  • Wisconsin Dells, WI
  • NPI 1487734380
  NPD
• Reedsburg Area Medical Center Inc

  • Rural Health Clinic/Center
  • La Valle, WI
  • NPI 1437049566
  NPD
• Reedsburg Area Medical Center, Inc.

  • Family Medicine Physician
  • Reedsburg, WI
  • NPI 1457780983
  NPD
• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1396110821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-372-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CASSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6726-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6726-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csullivan11816@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "csullivan11816@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jordan Lee Stittleburg, DC
• Paul Stoltz
• Shelby Stone, LCSW
• Sheila Kay Strait, RN
• Shelley Larice Strojny, FPMHNP-BC
• Kandis Kay Sullivan
• Philip A Sweet, M.D.
• Kelly Lynn Swenson, RN
• Shawnette Syvinski, RN
• George Szczerbaniuk

• Family Nurse Practitioner in Tomah, WI
• Providers in Tomah, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.