Active NPI
Rachel Maupin Sullivan, D.O.
- Family Medicine Physician
- Kansas City, MO
National Provider Identifier
1811258114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2015026164
- Practice address
- 4400 Broadway
Suite 400
Kansas City, MO 64111-3498 - Phone
- (816) 753-6552
- NPI assigned
- Jun 4, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | P8505 | TX | |
| Family Medicine Physician | 207Q00000X | 2015026164 | MO | Primary |
| Family Medicine Physician | 207Q00000X | 05-38365 | KS |
Addresses
Primary practice location
4400 Broadway
Suite 400
Kansas City, MO 64111-3498
Mailing address
4400 Broadway
Suite 400
Kansas City, MO 64111-3498
Phone (816) 753-6552
Other names 1
- Dr. Rachel Cartier Maupin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 11, 2024 through Sep 11, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-38365 | KS | MD | Family Medicine Physician |
| P8505 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1811258114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 BROADWAY",
"address_2": "SUITE 400",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641113498",
"telephone_number": "816-753-6552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 BROADWAY",
"address_2": "SUITE 400",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641113498",
"telephone_number": "816-753-6552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "RACHEL",
"middle_name": "MAUPIN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-04",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "P8505",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2015026164",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "05-38365",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RACHEL",
"last_name": "MAUPIN",
"middle_name": "CARTIER",
"prefix": "DR.",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.