Christina Ann Sullivan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP145126 Issued in TX

Practice address

347 E Parkwood Ave Ste a
Friendswood, TX 77546-5761

Phone

(281) 612-2406

NPI assigned

Feb 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Christina Ann Wallace Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christinawallace@paphcp-tx.direct.office.nextgen.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.

• Openloop Healthcare Partners PC

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  • NPI 1245820661

  Multi-Specialty, TX

  Medicare reassignment NPD
• Titan Men'S Health

  • Adult Medicine Physician
  • League City, TX
  • NPI 1053726141
  NPD (past)

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1609409549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 E PARKWOOD AVE STE A",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465761",
            "telephone_number": "281-612-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 E PARKWOOD AVE STE A",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775465761",
            "telephone_number": "281-612-2406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 E.F. Lowry Expressway",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Texas City",
            "state": "TX",
            "postal_code": "77591",
            "country_code": "US",
            "telephone_number": "281-559-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WALLACE",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Stone, M.D.
• Donald Calvin Stran, D.P.M.
• Kristin Rachelle Streich, PSYD
• Nattharat Suaysompol, DMD
• Ishwari Subedi, RN, BSN
• Sumant Agrawal, DDS, PA
• Summerville at Friendswood Associates, LP
• Suncoast Plastic Surgery, PLLC
• Sunny Acupuncture & Herb PLLC
• Sunshine Counseling Services, PLLC

• Family Nurse Practitioner in Friendswood, TX
• Providers in Friendswood, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.