Individual provider Active NPI

Kristin Sina Sullivan, APRN

  • Acute Care Nurse Practitioner
  • Muskogee, OK
National Provider Identifier
1417349275
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
86574 Issued in OK
Practice address
101 Rockefeller Dr
Muskogee, OK 74401-5056
Phone
(918) 494-8500
Fax
(918) 494-5455
NPI assigned
Mar 3, 2015
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 792822 TX
Nurse Practitioner 363L00000X 86574 OK
Acute Care Nurse Practitioner 363LA2100X 86574 OK Primary
Nurse Practitioner 363L00000X AP127645 TX
Critical Care Medicine Nurse Practitioner 363LC0200X 86574 OK

Addresses

Primary practice location

101 Rockefeller Dr
Muskogee, OK 74401-5056

Mailing address

6600 S Yale Ave Ste 1400
Tulsa, OK 74136-3331
Phone (888) 247-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK, IA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20150409001639 TX Practitioner - Nurse Practitioner 7618295353 Reassigns benefits to 3 organizations
I20160525002750 OK Practitioner - Nurse Practitioner 7618295353 Reassigns benefits to 4 organizations
I20250401003237 IA Practitioner - Nurse Practitioner 7618295353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians
North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

101 Rockefeller Dr
Suite 100
Muskogee, OK 74401-5050
Phone (918) 683-1831

115 Airport Rd
Sulphur Springs, TX 75482-2105
Phone (903) 885-7671

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.06 of 100Reported as apm
Quality
75.25
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
82.31
Improvement activities
40
Cost
62.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
792822TXMDRegistered Nurse
AP127645TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Oct 4, 2024 Accepting new patients
Midwest Hospitalist Group PLLC CurrentSince Mar 1, 2022 Accepting new patients
Apogee Medical Group Texas PA CurrentSince Mar 1, 2015 Accepting new patients
Thi Specialists LLC CurrentSince Oct 27, 2020 Accepting new patients
North Texas Physician Services, PLLC Nurse Practitioner CurrentSince Jul 28, 2024 Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients
Oklahoma Heart Inc PastSince Apr 1, 2020 Accepting new patients

Locations

101 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 683-1831

101 Rockefeller Dr
Ste 100
Muskogee, OK 74401
Phone (918) 684-2557

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

1145 S Utica Ave
Ste 460
Tulsa, OK 74104
Phone (918) 392-8884

2440 E 81st St
Tulsa, OK 74137
Phone (918) 392-8856

6151 S Yale Ave
Ste 100A
Tulsa, OK 74136
Phone (918) 494-2100

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

609 Medical Center Dr
Decatur, TX 76234
Phone (940) 626-1360

3200 N Tarrant Pkwy
Ft Worth, TX 76177
Phone (817) 382-6789

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 885-7671

719 W Coke Rd
Winnsboro, TX 75494
Phone (903) 342-3710

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4
  • Direct secure messaging: ksullivan284194@ahs.direct-ci.com
  • Direct secure messaging: ksullivan79592@direct.saintfrancis.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1417349275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363331",
            "telephone_number": "888-247-0125",
            "fax_number": "918-502-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROCKEFELLER DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015056",
            "telephone_number": "918-494-8500",
            "fax_number": "918-494-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KRISTIN",
        "middle_name": "SINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-03",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "792822",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "86574",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OK",
            "license": "86574",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP127645",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OK",
            "license": "86574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.