Wanda J Sullivan, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN073140 Issued in LA

Practice address

765 S Bonner St
Ruston, LA 71270-5801

Phone

(318) 202-5935

Fax

(318) 202-5933

NPI assigned

Oct 17, 2006

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

Medicare fee-for-service enrollment

Enrolled in LA

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsu Health Sciences Center Shreveport Faculty Group Practice 567 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lsu Health Monroe Hospital, Monroe, LA, CCN 190011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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 and National Provider Directory roles.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  LA

  Medicare reassignment Care Compare group NPD
• Cross Lake Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1013497114

  LA, Nurse Practitioner

  Medicare reassignment NPD
• University Health Shreveport LLC

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611

  LA, Nurse Practitioner

  Medicare reassignment NPD
• Bienville Parish

  • Rural Health Clinic/Center
  • Arcadia, LA
  • NPI 1316038441
  NPD (past)
• Boersma Clinic, LLC

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1104024686
  NPD (past)
• Brfhh Shreveport LLC

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1912909912
  NPD (past)
• Christus Health Northern Louisiana

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  NPD (past)
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  NPD (past)
• Quick Care of Ruston, L.L.C.

  • Specialist
  • Ruston, LA
  • NPI 1639252489
  NPD (past)

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

• Brfhh Monroe LLC

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1215939210

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1740360353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1839",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712731839",
            "telephone_number": "318-202-5935",
            "fax_number": "318-202-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 S BONNER ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705801",
            "telephone_number": "318-202-5935",
            "fax_number": "318-202-5933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "WANDA",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN073140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Allen Strickland Jr., CRNA
• Stronger Minds Therapy LLC
• Patrick Stuckey, D.D.S.
• Rebecca Meier Stutzman, LCSW-BACS
• Melissa Sullivan, NP
• Whitney Sumlin
• Brooke Nichole Sutton, NP
• Dustin Swafford
• SWC Ruston, LLC
• Daniel Takata, ATC

• All providers in Ruston, LA
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.