Carla Sullivan, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

3007730 Issued in KY

Practice address

2601 Kentucky Ave
Suite 300
Paducah, KY 42003-3817

Phone

(270) 443-5564

Fax

(270) 443-5549

NPI assigned

Oct 12, 2012

Last updated

Oct 12, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amago Inpatient Services LLCGroup PAC ID 7214259704, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amago Inpatient Services LLC

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1174925994
  Medicare reassignment Care Compare group
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  KY

  Medicare reassignment NPD
• Western Baptist Medical Ventures, Inc.

  dba Paducah Neurosurgical Center

  • Neurological Surgery Physician
  • Paducah, KY
  • NPI 1316017080
  NPD (past)

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1841542941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 300",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-443-5564",
            "fax_number": "270-443-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 300",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-443-5564",
            "fax_number": "270-443-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CARLA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3007730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Success Vision Express of Paducah, LLC (Success Vision Express of Paducah)
• Elizabeth Suiter, LCSW
• Megan K Suiter
• Brianna Katherine Sullivan, PHARM D
• Caitlin Sullivan
• Charles Blake Sullivan, DPT
• Christa Lea Sullivan
• Cody Sullivan, MD
• Heather R Sullivan
• Toshia Donyelle Sullivan, COTA/L

• Acute Care Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Acute Care Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.

Verify at the official NPI Registry.