Shelby Lynne Sullivan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

118920 Issued in MA

Practice address

275 Sandwich St
Plymouth, MA 02360-2183

Phone

(508) 746-2000

NPI assigned

Jan 29, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Physicians of Harvard Medical Faculty Physicians at Beth IsGroup PAC ID 6305749987, shared by 7 NPIs, 566 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Diagnostic Radiology Physician
  • Milton, MA
  • NPI 1245773308
  Medicare reassignment NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Emergency Medical Services (Emergency Medicine) Physician
  • Boston, MA
  • NPI 1952358533
  Medicare reassignment NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Anesthesiology Physician
  • Plymouth, MA
  • NPI 1568859643
  NPD
• Associated Physicians of Harvard Medical Faculty Physicians at Beth Is

  • Multi-Specialty Clinic/Center
  • Boston, MA
  • NPI 1861216038
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Deaconess Hospital Plymouth, Inc.

  • General Acute Care Hospital
  • Plymouth, MA
  • NPI 1043299001
  Care Compare affiliation

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545609600000",
    "number": "1407354087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-746-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-746-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHELBY",
        "middle_name": "LYNNE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2018-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "118920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118920",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen V Sullivan, LMHC
• Michael James Sullivan, PT
• Patricia E Sullivan, M.D.
• Paul Joseph Sullivan, LICSW
• Sheila Sullivan, M.ED, OTR/L, CEIS
• Susan Catherine Sullivan, PA-C
• Tom Sullivan
• Zheng Sun
• Sunny Smile IX Inc
• Surf to Summit Wellness

• Certified Registered Nurse Anesthetist in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Certified Registered Nurse Anesthetist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.