Megan Sonja Sullivan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7650547-4409 Issued in UT

Practice address

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846

Phone

(801) 359-2256

NPI assigned

Oct 23, 2020

Last updated

Oct 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Confederated Tribes of the Goshute ReservationGroup PAC ID 0042451650, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Confederated Tribes of the Goshute Reservation

  • General Practice Physician
  • Ibapah, UT
  • NPI 1750510277

  TX

  Medicare reassignment Care Compare group NPD
• Confederated Tribes of the Goshute Reservation

  • Clinic Pharmacy
  • Salt Lake City, UT
  • NPI 1467811562
  NPD (past)

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1669071395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11241 S SANDCREST CIR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840947014",
            "telephone_number": "503-758-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MEGAN",
        "middle_name": "SONJA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7650547-4409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Lee Sullivan
• Kristen Gallup Sullivan, OTR/L
• Lauren Sullivan
• Lindsay Sullivan
• Marisol Sullivan
• Sydney Sullivan
• Tricia Sullivant, CSW
• Cindy Emilia Alexandra Sumarauw, DDS
• Daniel D. Summerfield, MD
• Gerald Stohl Summerhays, DDS, MS

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.