Individual provider Active NPI

Debra Ann Ardeel-Sullivan, NP

  • Family Health Clinical Nurse Specialist
  • Indianapolis, IN
National Provider Identifier
1538152244
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
71000233A Issued in IN
Practice address
8177 Clearvista Pkwy
Indianapolis, IN 46256-1662
Phone
(317) 621-7801
Fax
(317) 621-7205
NPI assigned
Aug 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 71000233A IN Primary
Registered Nurse 163W00000X 71000233B IN

Addresses

Primary practice location

8177 Clearvista Pkwy
Indianapolis, IN 46256-1662

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other identifiers 1

IdentifierTypeStateIssuer
200279630MedicaidIN

Other names 1

  • Debra Ann Sullivan Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dardeelsullivan6008@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20051006000163 IN Practitioner - Nurse Practitioner 0345221099 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71000233BINMDRegistered Nurse
71000233AINMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Sep 28, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Sep 28, 2011 Accepting new patients
Minuteclinic Diagnostics of Indiana, LLC Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1030 S Scatterfield Rd
Anderson, IN 46012
Phone (765) 644-5025

11911 N Meridian St
Ste 150
Carmel, IN 46032
Phone (317) 621-6700

1664 W Smith Valley Rd
Greenwood, IN 46142
Phone (317) 887-7640

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

8177 Clearvista Pkwy
Indianapolis, IN 46256
Phone (317) 621-7800

1703 N Post Rd
Indianapolis, IN 46219
Phone (317) 355-3200

16865 Clover Rd
Noblesville, IN 46060
Phone (317) 621-1288

9669 E 146th St
Ste 100
Noblesville, IN 46060
Phone (317) 621-3434

Interoperability endpoints

  • Direct secure messaging: dardeelsullivan6008@ecommunitydirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1538152244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8177 CLEARVISTA PKWY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561662",
            "telephone_number": "317-621-7801",
            "fax_number": "317-621-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDEEL-SULLIVAN",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-27",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "IN",
            "license": "71000233A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "71000233B",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279630",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dardeelsullivan6008@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "8177 Clearvista Pkwy",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "SULLIVAN",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.