Individual provider Active NPI

Veronica Valle-Sullivan, NP

  • Family Nurse Practitioner
  • Laredo, TX
National Provider Identifier
1760818751
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AT123771 Issued in TX
Practice address
7109 Bartlett Ave Sute 101
Laredo, TX 78041
Phone
(956) 717-5775
Fax
(956) 717-5875
NPI assigned
Sep 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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 725649 TX
Family Nurse Practitioner 363LF0000X AT123771 TX Primary

Addresses

Primary practice location

7109 Bartlett Ave Sute 101
Laredo, TX 78041

Mailing address

7109 Bartlett Ave Sute 101
Laredo, TX 78041
Phone (956) 717-5775

Other identifiers 1

IdentifierTypeStateIssuer
725649OtherTXLICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131203001116 TX Practitioner - Nurse Practitioner 9133355738 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
725649TXMDFamily Nurse Practitioner
AT123771TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrics and Gynecology Associates of Laredo, P.a. CurrentSince Dec 1, 2022 Accepting new patients

Locations

7109 N Bartlett Ave
Ste 101
Laredo, TX 78041
Phone (956) 717-5775

Organizations & group practices 1

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": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1760818751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 BARTLETT AVE SUTE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-717-5775",
            "fax_number": "956-717-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 BARTLETT AVE SUTE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78041",
            "telephone_number": "956-717-5775",
            "fax_number": "956-717-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLE-SULLIVAN",
        "first_name": "VERONICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "725649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AT123771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "725649",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.