Active NPI
Katie Marie Sullivan, NP
- Nurse Practitioner
- East Lansing, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704327523
- Practice address
- 4650 S Hagadorn Rd Ste 100
East Lansing, MI 48823-5386 - Phone
- (517) 353-4830
- Fax
- (517) 355-2134
- NPI assigned
- May 19, 2022
- Last updated
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704327523 | MI | |
| Nurse Practitioner | 363L00000X | 4704327523 | MI | Primary |
Addresses
Primary practice location
4650 S Hagadorn Rd Ste 100
East Lansing, MI 48823-5386
Mailing address
804 Service Rd Ste A202
East Lansing, MI 48824-7015
Other practice location 1
1540 Lake Lansing Rd Ste G6
Lansing, MI 48912-3757
Phone (517) 482-7246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4650 S Hagadorn Rd
Suite 100
East Lansing, MI 48823-5386
Phone (517) 353-4830
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704327523 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Msu Health Care Inc. | Current | Accepting new patients | |
| Msu Health Care Inc | Current | Accepting new patients | |
| Msu Health Care Inc | Current | Accepting new patients | |
| Msu Health Care Inc. | Past | Accepting new patients |
Locations
4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830
4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144
804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976
1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080
Interoperability endpoints
- katie.sullivan.1@25394.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Allergy & Immunology Physician
- East Lansing, MI
- NPI 1700418670
-
- Endocrinology, Diabetes & Metabolism Physician
- East Lansing, MI
- NPI 1821620808
-
- Physical Therapist
- East Lansing, MI
- NPI 1689206419
-
- Diagnostic Radiology Physician
- East Lansing, MI
- NPI 1275165052
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba University of Michigan Health-Sparrow Lansing
- General Acute Care Hospital
- Lansing, MI
- NPI 1073588711
-
dba Thoracic Cardiovascular Institute
- General Acute Care Hospital
- Lansing, MI
- NPI 1760710719
-
- General Acute Care Hospital
- Lansing, MI
- NPI 1134104672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1801533864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SERVICE RD STE A202",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488247015",
"fax_number": "517-432-3928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 S HAGADORN RD STE 100",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488235386",
"telephone_number": "517-353-4830",
"fax_number": "517-355-2134"
}
],
"practiceLocations": [
{
"address_1": "1540 Lake Lansing Rd Ste G6",
"address_purpose": "LOCATION",
"city": "Lansing",
"state": "MI",
"postal_code": "489123757",
"country_code": "US",
"telephone_number": "517-482-7246",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KATIE",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-19",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704327523",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704327523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Lansing, MI
Sources for this page
- 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; 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.