Chasity Renae Sullivan, APRN

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

223808 Issued in AR

Practice address

10929 Old Highway 71
Fort Smith, AR 72916-8160

Phone

(479) 250-1562

NPI assigned

Apr 21, 2023

Last updated

Apr 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 AR, OK2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Wound Solutions of Nwa, LLC

  • Clinic/Center
  • Rogers, AR
  • NPI 1043904261
  Medicare reassignment NPD
• Belclin LLC

  • Neurology Physician
  • Fort Smith, AR
  • NPI 1578021903
  NPD
• Apex Wound Specialists LLC

  • Clinic/Center
  • Broken Arrow, OK
  • NPI 1902630122
  NPD
• Wound Solutions of Central Arkansas LLC

  • Clinic/Center
  • Jonesboro, AR
  • NPI 1447952346
  NPD (past)

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1851088561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 ROYAL SCOTS WAY",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729089332",
            "telephone_number": "918-577-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10929 OLD HIGHWAY 71",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729168160",
            "telephone_number": "479-250-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHASITY",
        "middle_name": "RENAE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "223808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Sudbrink, MD
• Janice Sudbrink, APRN
• Billie Sudigala
• Shreya Sukralia
• Brittany N Sullivan
• Eric Scott Sullivan, DO
• Ryan Sullivan, D.O.
• Mari Sumbler
• Balasasikumar Sundaram, MD
• Vikki L Sutterfield, MD

• Family Medicine Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.