Active NPI
Casey Seton Sullivan, RN
- Family Nurse Practitioner
- Hagerstown, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R191013
- Practice address
- 12821 Oak Hill Ave
Hagerstown, MD 21742-2940 - Phone
- (301) 733-0300
- NPI assigned
- Oct 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | R191013 | MD | |
| Family Nurse Practitioner | 363LF0000X | R191013 | MD | Primary |
Addresses
Primary practice location
12821 Oak Hill Ave
Hagerstown, MD 21742-2940
Mailing address
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8000
Other practice location 1
11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8623
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | n/a |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12821 Oak Hill Ave
Hagerstown, MD 21742-2940
Phone (301) 733-0300
Hospital & facility affiliations
- Meritus Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R191013 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Practices of Antietam, LLC | Current | Accepting new patients | |
| Medical Practices of Antietam LLC | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
604 Solarex Ct
Unit 207
Frederick, MD 21703
Phone (240) 439-4344
12821 Oak Hill Ave
Hagerstown, MD 21742
Phone (301) 733-0300
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
11110 Medical Campus Rd
Ste 224
Hagerstown, MD 21742
Phone (301) 665-4560
3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150
Organizations & group practices 3
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.
-
- Clinic/Center
- Hagerstown, MD
- NPI 1710854963
-
- General Practice Physician
- Hagerstown, MD
- NPI 1558430843
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hagerstown, MD
- NPI 1942281266
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1457015372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11116 MEDICAL CAMPUS RD",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217426710",
"telephone_number": "301-790-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12821 OAK HILL AVE",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217422940",
"telephone_number": "301-733-0300"
}
],
"practiceLocations": [
{
"address_1": "11116 Medical Campus Rd",
"address_purpose": "LOCATION",
"city": "Hagerstown",
"state": "MD",
"postal_code": "217426710",
"country_code": "US",
"telephone_number": "301-790-8623",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CASEY",
"middle_name": "SETON",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-27",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MD",
"license": "R191013",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R191013",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "n/a",
"affiliation": "N",
"address_1": "22006 Navaho Crl",
"city": "SMITHSBURG",
"state": "MD",
"country_code": "US",
"postal_code": "21783",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.