Individual provider Active NPI

Meghan Sullivan, CNP

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1740694074
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2014018618 Issued in MO
Practice address
12855 N 40 Dr Ste 280
Saint Louis, MO 63141-8657
Phone
(314) 432-4415
NPI assigned
Jun 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014018618 MO
Nurse Practitioner 363L00000X 2014018618 MO Primary

Addresses

Primary practice location

12855 N 40 Dr Ste 280
Saint Louis, MO 63141-8657

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 432-4415

Other practice location 1

3920 Hampton Ave
Saint Louis, MO 63109-1401
Phone (314) 236-2795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20140819002494 MO Practitioner - Nurse Practitioner 6103044995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

12855 N 40 Dr
Suite 280
Saint Louis, MO 63141-8657
Phone (314) 432-4415

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Nurse Practitioner CurrentSince May 5, 2025 Accepting new patients
Mercy Clinic East Communities CurrentSince May 5, 2025 Accepting new patients

Locations

12855 N 40 Dr
Ste 280
Saint Louis, MO 63141
Phone (314) 432-4344

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1740694074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-432-4415",
            "fax_number": "314-432-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-432-4415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 Hampton Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631091401",
            "country_code": "US",
            "telephone_number": "314-236-2795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MEGHAN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-14",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014018618",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2014018618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.