Individual provider Active NPI

Kailee Renee Sullivan, APRN-CNP

  • Family Nurse Practitioner
  • Ada, OK
National Provider Identifier
1902278609
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
103054 Issued in OK
Practice address
721 Better Now PLZ
Ada, OK 74820-2279
Phone
(580) 272-0025
Fax
(580) 272-6559
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 103054 OK Primary

Addresses

Primary practice location

721 Better Now PLZ
Ada, OK 74820-2279

Mailing address

721 Better Now PLZ
Ada, OK 74820-2279
Phone (580) 272-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20160727000227 OK Practitioner - Nurse Practitioner 3476846528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medcore, LLCGroup PAC ID 3173025848, 2 clinicians

Practice addresses (Care Compare)

721 Better Now PLZ
Ada, OK 74820-2279
Phone (580) 272-0025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
103054OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medcore, LLC CurrentSince Oct 1, 2025 Accepting new patients
Summit Medical Center Past Accepting new patients
Ross Enterprises Inc Family PastSince Jan 15, 2021 Accepting new patients
Mercy Hospital Ada, Inc Past Accepting new patients

Locations

721 Better Now Plz
Ada, OK 74820
Phone (580) 272-0025

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1902278609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 BETTER NOW PLZ",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748202279",
            "telephone_number": "580-272-0025",
            "fax_number": "580-272-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KAILEE",
        "middle_name": "RENEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "103054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, OK

Sources for this page

Verify at the official NPI Registry.