Madisyn Sullivan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.2405 Issued in AL

Practice address

39 Windy Hill Rd
Taylor, AL 36305

Phone

(334) 793-8111

NPI assigned

Jul 1, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Madisyn Good Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment Care Compare group
• Houston County Healthcare Authority

  dba SAMC- Profee Billing

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134

  Physician Assistant

  NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Physician Assistant

  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD

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

• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1437994340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 DAWSON LN",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363304594",
            "telephone_number": "440-240-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WINDY HILL RD",
            "city": "TAYLOR",
            "state": "AL",
            "postal_code": "36305",
            "telephone_number": "334-793-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MADISYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.2405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISYN",
            "last_name": "GOOD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Arica Monique Parker
• Amanda Joyce Blurton Waters
• Tabitha Renae Waters

• Physician Assistant in Taylor, AL
• Providers in Taylor, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.