Chantal Sullivan Aprn-BC PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CHANTAL SULLIVAN APRN-BC PLLC

Practice address

8990 Lorraine Rd
Gulfport, MS 39503-4176

Phone

(228) 331-3310

NPI assigned

Mar 9, 2020

Last updated

Mar 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Chantal Sullivan, APRNNPI 1740811280

Title

Nurse Practitioner

Phone

(228) 331-3310

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chantal Sullivan, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gulfport, MS
  • NPI 1740811280
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1437784550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 COURTHOUSE RD UNIT 6",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395074110",
            "telephone_number": "720-271-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034176",
            "telephone_number": "228-331-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANTAL SULLIVAN APRN-BC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "CHANTAL",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "228-331-3310",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tysheka Cephas, CRNP, PMHNP-BC
• CFV, Inc
• Walter Gillican Chamberlain Jr., M.ED, LPC, BCBA
• Mona Chambers, BS
• Cherie Champagne, M.D.
• Taylor Bertrand Chapin, MD
• Valarie Anne Chapmon, LCSW
• Charles E Schlosser, III MD LLC
• Charles G. Wood D.M.D.P.a.
• Charlton Bryan Blakeney D.M.D.

• Psychiatric/Mental Health Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.