Corey Sullivan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209012309 Issued in IL

Practice address

1005 Broadway St
Quincy, IL 62301-2834

Phone

(217) 223-8400

Fax

(217) 223-9945

NPI assigned

Jan 2, 2015

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Rush Medical College of Rush University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blessing Hospital Hospital, Quincy, IL, CCN 140015

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

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.

• Blessing Hospital

  • Anesthesiology Physician
  • Quincy, IL
  • NPI 1255515342
  Medicare reassignment Care Compare group NPD
• Blessing Hospital

  dba Blessing Health Monroe City

  • Rural Health Clinic/Center
  • Monroe City, MO
  • NPI 1013683507
  NPD

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

• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1790173557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "COREY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209012309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine M Stupavsky, LPC, LCPC
• Kent Joseph Sturhahn, DMD
• Anandi Subbian
• Deanna Sublette
• Brady Sullivan, BA,MHP
• Douglas N Sullivant, MD
• Ashley Summers, RSA
• Sunset Home
• Sunset Home
• Sunset Home

• Certified Registered Nurse Anesthetist in Quincy, IL
• Providers in Quincy, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.