Colby Keith Sullivan, ACNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11002698 Issued in FL

Practice address

5149 N 9TH Ave
Pensacola, FL 32504-8756

Phone

(850) 479-7200

NPI assigned

Aug 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colby.sullivan@hca5.eclinicaldirectplus.com

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.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Nautilus Health Care Group LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Melbourne, FL
  • NPI 1912013558

  Nurse Practitioner

  Medicare reassignment NPD
• Nautilus Health Care Group, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Kokomo, IN
  • NPI 1013234699
  NPD
• Advanced Wound Systems LLC

  • Durable Medical Equipment & Medical Supplies
  • St Petersburg, FL
  • NPI 1508054271
  NPD (past)

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

• West Florida Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1639116726
  Care Compare affiliation

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1528613734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11982",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325241982",
            "telephone_number": "850-479-1805",
            "fax_number": "850-479-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048756",
            "telephone_number": "850-479-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5149 N 9th Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048734",
            "country_code": "US",
            "telephone_number": "850-479-1805",
            "fax_number": "850-479-1829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "COLBY",
        "middle_name": "KEITH",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2022-01-04",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "COLBY.SULLIVAN@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5149 N 9th Ave Ste 120",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325048734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark Suhrer, DO
• Steven J Sukstorf, MD
• Amy K Sullivan, MD, PHD
• Brett S Sullivan, M.D.
• Brittany P Sullivan, CRNA
• John Robert Sullivan, M.D.
• Kevin Sullivan, MOTR-L
• Raymond Sullivan, LMHC
• Joseph Bryan Summerford, RPH
• Andrew Summerlin, LAT, ATC

• Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.