Individual provider Active NPI

Casey Seton Sullivan, RN

  • Family Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1457015372
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R191013 Issued in MD
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

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220217001504 MD Practitioner - Nurse Practitioner 1153714027 Reassigns benefits to 1 organization

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
Medical Practices of Antietam, LLCGroup PAC ID 2567353865, 229 clinicians

Practice addresses (Care Compare)

12821 Oak Hill Ave
Hagerstown, MD 21742-2940
Phone (301) 733-0300

Hospital & facility affiliations

  • Meritus Medical Center Hospital, Hagerstown, MD, CCN 210001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R191013MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Practices of Antietam, LLC CurrentSince Feb 21, 2022 Accepting new patients
Medical Practices of Antietam LLC CurrentSince Feb 21, 2022 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.